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General NPI Number Information
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NPI Number | 1306632062
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Entity Type | Organization
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Legal Business Name | LIFESPAN OF MASSACHUSETTS - TAUNTON INC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 235 N PEARL ST
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City | BROCKTON
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State | MA
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Zip | 02301-1794
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Country | US
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Telephone | 401-444-7797
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Fax |
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Provider Business Mailing Address
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Address Line | 117 ELLENFIELD ST STE 101
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City | PROVIDENCE
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State | RI
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Zip | 02905-4541
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Country | US
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Telephone | 401-444-7797
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Fax | 401-444-6912
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Authorized Official
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Title or Position | SVP FINANCE
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Name | EVA GREENWOOD
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Credential |
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Telephone | 401-444-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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