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NPI Code Detail

MEDICARE: CAMP THOREAU INC

MEDICARE: CAMP THOREAU INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1023415460
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMP THOREAU INC
Provider Business Mailing Address
First Line : 275 FOREST RIDGE RD
Second Line :
City : CONCORD
State : MA
Zip : 01742-3830
Country : US
Telephone Number : 978-831-1200
Fax Number :
Provider Business Practice Location Address
First Line : 275 FOREST RIDGE RD
Second Line :
City : CONCORD
State : MA
Zip : 01742-3830
Country : US
Telephone Number : 978-831-1200
Fax Number :
Authorized Official
Title or Position : CEO AND PRESIDENT
Name : FAITH PULIS
Credential :
Telephone Number : 978-831-1230
Provider Enumeration Date : 12/01/2014
Last Update Date : 12/01/2014

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Directions to “CAMP THOREAU INC ” Practice Location

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