Provider Demographics
NPI:1033358536
Name:IDEAL HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:IDEAL HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:781-562-0468
Mailing Address - Street 1:50 OLIVER ST STE 209
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1446
Mailing Address - Country:US
Mailing Address - Phone:781-562-0468
Mailing Address - Fax:781-262-8218
Practice Address - Street 1:50 OLIVER ST STE 209
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1446
Practice Address - Country:US
Practice Address - Phone:781-562-0468
Practice Address - Fax:781-262-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-07
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA184437363L00000X
MA194268363LA2200X
MA184424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110085488AMedicaid
MA110085488AMedicaid