Provider Demographics
NPI:1386898724
Name:LORETTA H. WEST
Entity type:Organization
Organization Name:LORETTA H. WEST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:781-383-8585
Mailing Address - Street 1:4 LINCON STREET
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045
Mailing Address - Country:US
Mailing Address - Phone:781-718-9950
Mailing Address - Fax:
Practice Address - Street 1:135 KING ST
Practice Address - Street 2:SUITE 600
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1396
Practice Address - Country:US
Practice Address - Phone:781-383-8585
Practice Address - Fax:781-383-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6391650001Medicare NSC