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General NPI Number Information
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NPI Number | 1245370931
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Entity Type | Organization
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Legal Business Name | NORTHFIELD MT HERMON SCHOOL-O'CONNOR HEALTH CTR
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 206 MAIN ST
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City | NORTHFIELD
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State | MA
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Zip | 01360-1050
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Country | US
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Telephone | 413-498-3407
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Fax | 413-498-3147
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Provider Business Mailing Address
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Address Line | 206 MAIN ST
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City | NORTHFIELD
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State | MA
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Zip | 01360-1050
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Country | US
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Telephone | 413-498-3407
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Fax | 413-498-3147
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | BONNIE GRAVES
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Credential |
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Telephone | 413-498-3407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2338
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License Number State | MA
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