Provider Demographics
NPI:1033100649
Name:INTERIM HEALTHCARE OF WESTERN MASS., INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF WESTERN MASS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOENBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-734-6900
Mailing Address - Street 1:442 WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-2581
Mailing Address - Country:US
Mailing Address - Phone:413-734-6900
Mailing Address - Fax:413-730-4282
Practice Address - Street 1:442 WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-2581
Practice Address - Country:US
Practice Address - Phone:413-734-6900
Practice Address - Fax:413-730-4282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0603147Medicaid
MA120213OtherBLUE CROSS BLUE SHIELD
227213Medicare ID - Type Unspecified