MEDICARE: INTERIM HEALTHCARE OF WESTERN MASS., 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
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	120213	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1033100649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF WESTERN MASS., INC.

Provider Business Mailing Address
First Line	:	442 WESTFIELD ST
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01089-2581
Country	:	US
Telephone Number	:	413-734-6900
Fax Number	:	413-730-4282

Provider Business Practice Location Address
First Line	:	442 WESTFIELD ST
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01089-2581
Country	:	US
Telephone Number	:	413-734-6900
Fax Number	:	413-730-4282

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. WILLIAM SCHOENBORN
Credential	:
Telephone Number	:	413-734-6900

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	08/22/2020

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