Healthcare Provider Details

I. General information

NPI: 1417951799
Provider Name (Legal Business Name): LASALLE HEALTH SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 E WASHINGTON ST STE 2
NORTH ATTLEBORO MA
02760-2488
US

IV. Provider business mailing address

652 E WASHINGTON ST STE 2
NORTH ATTLEBORO MA
02760-2488
US

V. Phone/Fax

Practice location:
  • Phone: 508-699-2090
  • Fax: 509-699-5932
Mailing address:
  • Phone: 508-699-2090
  • Fax: 509-699-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateMA

VIII. Authorized Official

Name: MR. JON F LOMBARDI
Title or Position: PRESIDENT
Credential:
Phone: 508-699-2090