MEDICARE: CITY OF HAVERHILL

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	251300000X	Local Education Agency (LEA)

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

General Provider Information

NPI Number	:	1295863595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF HAVERHILL

Provider Business Mailing Address
First Line	:	4 SUMMER ST STE 104
Second Line	:
City	:	HAVERHILL
State	:	MA
Zip	:	01830-5843
Country	:	US
Telephone Number	:	978-374-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 SUMMER ST
Second Line	:
City	:	HAVERHILL
State	:	MA
Zip	:	01830-5836
Country	:	US
Telephone Number	:	978-374-3400
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SUPERINTENDENT
Name	:	KARA KOSMES
Credential	:
Telephone Number	:	978-374-3400

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/11/2008

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Directions to “CITY OF HAVERHILL ” Practice Location

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