Provider Demographics
NPI:1366420663
Name:UMASS MEMORIAL HEALTH CARE, INC.
Entity type:Organization
Organization Name:UMASS MEMORIAL HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ST. GERMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-798-3171
Mailing Address - Street 1:60 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2205
Mailing Address - Country:US
Mailing Address - Phone:978-728-0621
Mailing Address - Fax:978-728-0655
Practice Address - Street 1:60 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2205
Practice Address - Country:US
Practice Address - Phone:978-728-0621
Practice Address - Fax:978-798-3137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UMASS MEMORIAL HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-06
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6325OtherFALLON HEALTH PLAN
MD120009OtherBLUE CROSS
MA702076OtherHARVARDPILGRIM HEALTH PLA
MA786419OtherNETWORK HEALTH
MA801325OtherTUFTS HEALTH PLAN
MA227009Medicare Oscar/Certification
MA786419OtherNETWORK HEALTH
MA801325OtherTUFTS HEALTH PLAN