Healthcare Provider Details

I. General information

NPI: 1982607537
Provider Name (Legal Business Name): GREATER NEW BEDFORD COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 PURCHASE ST
NEW BEDFORD MA
02740-6232
US

IV. Provider business mailing address

874 PURCHASE ST
NEW BEDFORD MA
02740
US

V. Phone/Fax

Practice location:
  • Phone: 508-992-6553
  • Fax: 508-984-8420
Mailing address:
  • Phone: 508-992-6553
  • Fax: 508-997-2498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number4005
License Number StateMA

VIII. Authorized Official

Name: MS. CHERYL A BARTLETT
Title or Position: CEO
Credential:
Phone: 508-992-6553