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COMMONWEALTH OF MASSACHUSETTS NPI 1902240047


NPI Information

NPI: 1902240047
Provider Name: COMMONWEALTH OF MASSACHUSETTS

Other Name: MASSACHUSETTS MARITIME ACADEMY

Classification: Clinic/Center - 261QS1000X
Entity Type: Organization

Specialization: Student Health

CLIA Number: 22D1017765

Address:
101 ACADEMY DR
HEALTH SERVICES
BUZZARDS BAY, MA
ZIP 02532
Phone: (508) 830-5048
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COMMONWEALTH OF MASSACHUSETTS is a student health clinic center in Buzzards Bay, MA. COMMONWEALTH OF MASSACHUSETTS NPI is 1902240047. The provider is registered as an organization entity type.
The provider Other Name Is Massachusetts Maritime Academy.

The provider's business location address is:

101 ACADEMY DR
HEALTH SERVICES
BUZZARDS BAY, MA
ZIP 02532-405
Phone: (508) 830-5048
Fax: (508) 830-5004

The provider's authorized official is Jeffrey Cukor .
The authorized official title is Director, Health Services and has the following contact phone number (508) 830-5048.

The CLIA number assigned to this NPI record is 22D1017765 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2013 and was last updated on 4/19/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QS1000XClinic/CenterStudent HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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