Provider Demographics
NPI:1285388389
Name:MDS GROUP LLC
Entity type:Organization
Organization Name:MDS GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELLECHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-216-6201
Mailing Address - Street 1:6 LIBERTY SQ STE 2607
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-5800
Mailing Address - Country:US
Mailing Address - Phone:617-960-9543
Mailing Address - Fax:
Practice Address - Street 1:6 LIBERTY SQ STE 2607
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-5800
Practice Address - Country:US
Practice Address - Phone:617-216-6201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health