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General NPI Number Information
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NPI Number | 1790174696
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Entity Type | Organization
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Legal Business Name | IHS OF MASSACHUSETTS, LLC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 587 WASHINGTON ST
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City | WEYMOUTH
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State | MA
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Zip | 02188-3441
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Country | US
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Telephone | 781-871-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 BROKEN SOUND PKWY STE 508
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City | BOCA RATON
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State | FL
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Zip | 33487-2765
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Country | US
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Telephone | 561-443-0743
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/COO
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Name | KATHLEEN MCDONNELL
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Credential |
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Telephone | 954-840-0433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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