MEDICARE: EMTAR HEALTH CARE 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	207Q00000X	Family Medicine Physician	47195	MA

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	:	1346395894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMTAR HEALTH CARE INC

Provider Business Mailing Address
First Line	:	42 ASBURY ST
Second Line	:
City	:	SOUTH HAMILTON
State	:	MA
Zip	:	01982-1808
Country	:	US
Telephone Number	:	978-468-4101
Fax Number	:	978-468-7067

Provider Business Practice Location Address
First Line	:	42 ASBURY ST
Second Line	:
City	:	SOUTH HAMILTON
State	:	MA
Zip	:	01982-1808
Country	:	US
Telephone Number	:	978-468-4101
Fax Number	:	978-468-7067

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. MICHAEL A EDWARDS
Credential	:
Telephone Number	:	978-468-4101

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	08/22/2020

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