Provider Demographics
NPI:1306836465
Name:SURGI-CARE INC
Entity type:Organization
Organization Name:SURGI-CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE/CONTRACT OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DILIDDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-290-1807
Mailing Address - Street 1:71 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1105
Mailing Address - Country:US
Mailing Address - Phone:800-797-8744
Mailing Address - Fax:
Practice Address - Street 1:3 FEDERAL ST STE 110
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-3500
Practice Address - Country:US
Practice Address - Phone:800-797-8744
Practice Address - Fax:800-338-6304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1530691Medicaid
ME151040002Medicaid
CT004194403Medicaid
VT1008716Medicaid
MA1533762Medicaid
RI2546900Medicaid
NH30761573Medicaid
NH30761573Medicaid