Provider Demographics
NPI:1992878102
Name:CITY OF SPRINGFIELD
Entity type:Organization
Organization Name:CITY OF SPRINGFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAULTON HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-787-6456
Mailing Address - Street 1:95 STATE STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-2000
Mailing Address - Country:US
Mailing Address - Phone:413-787-6740
Mailing Address - Fax:413-787-6458
Practice Address - Street 1:95 STATE STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-2000
Practice Address - Country:US
Practice Address - Phone:413-787-6744
Practice Address - Fax:413-787-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y11034Medicare UPIN