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NPI Code Detail

MEDICARE: RADIUS EASTON OPERATING LLC

MEDICARE: RADIUS EASTON OPERATING LLC
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
1314000000XSkilled Nursing Facility0928461MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255328456
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIUS EASTON OPERATING LLC
Provider Business Mailing Address
First Line : 184 LINCOLN ST
Second Line :
City : NORTH EASTON
State : MA
Zip : 02356-1799
Country : US
Telephone Number : 508-238-7053
Fax Number : 508-238-7049
Provider Business Practice Location Address
First Line : 184 LINCOLN ST
Second Line :
City : NORTH EASTON
State : MA
Zip : 02356-1799
Country : US
Telephone Number : 508-238-7053
Fax Number : 508-238-7049
Authorized Official
Title or Position : BUSINESS OFFICE MANAGER
Name : MRS. LISA ANN ROACH
Credential :
Telephone Number : 508-238-7053
Provider Enumeration Date : 10/03/2005
Last Update Date : 08/22/2020

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Directions to “RADIUS EASTON OPERATING LLC ” Practice Location

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