Provider Demographics
NPI:1346430253
Name:SPECTRUM HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:SPECTRUM HEALTH SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANGLOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-792-5400
Mailing Address - Street 1:10 MECHANIC ST.
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608
Mailing Address - Country:US
Mailing Address - Phone:508-792-5400
Mailing Address - Fax:508-831-0074
Practice Address - Street 1:585 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1906
Practice Address - Country:US
Practice Address - Phone:508-854-3320
Practice Address - Fax:508-753-5051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECTRUM HEALTH SYSTEMS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1308785Medicaid
MA000000008463OtherBMC HEALTHNET
MA1002900OtherBEACON
MA1306421OtherMBHP
MA690527OtherTUFTS
MAM18684OtherBCBS
MA1306421OtherMBHP