Healthcare Provider Details

I. General information

NPI: 1568688950
Provider Name (Legal Business Name): FS COMMONWEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 REHABILITATION WAY
WOBURN MA
01801-6003
US

IV. Provider business mailing address

220 PAWTUCKET ST
LOWELL MA
01854-3573
US

V. Phone/Fax

Practice location:
  • Phone: 978-446-1729
  • Fax:
Mailing address:
  • Phone: 978-446-1729
  • Fax: 978-446-1643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANN M STEPHEN
Title or Position: PATIENT ACCOUNTS MANAGER
Credential:
Phone: 978-446-1729