Provider Demographics
NPI:1194193193
Name:PARENT CO INC
Entity type:Organization
Organization Name:PARENT CO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PARENT
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:413-525-6003
Mailing Address - Street 1:200 N MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2392
Mailing Address - Country:US
Mailing Address - Phone:413-525-6003
Mailing Address - Fax:413-525-9009
Practice Address - Street 1:200 N MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2392
Practice Address - Country:US
Practice Address - Phone:413-525-6003
Practice Address - Fax:413-525-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine