Provider Demographics
NPI:1750799326
Name:IASIS SOLUTIONS
Entity type:Organization
Organization Name:IASIS SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NDORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-454-4186
Mailing Address - Street 1:803 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5007
Mailing Address - Country:US
Mailing Address - Phone:774-414-4186
Mailing Address - Fax:
Practice Address - Street 1:50 LEXINGTON ST # 2
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8219
Practice Address - Country:US
Practice Address - Phone:617-454-4186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN27515363LF0000X
261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty