Healthcare Provider Details

I. General information

NPI: 1730622614
Provider Name (Legal Business Name): METROCARE OF SPRINGFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51-59 TAYLOR ST
SPRINGFIELD MA
01103-1114
US

IV. Provider business mailing address

51-59 TAYLOR ST
SPRINGFIELD MA
01103-1114
US

V. Phone/Fax

Practice location:
  • Phone: 413-377-7777
  • Fax:
Mailing address:
  • Phone: 413-377-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number110112919B
License Number StateMA

VIII. Authorized Official

Name: ALEX EYDINOV
Title or Position: MANAGER
Credential:
Phone: 413-377-7777