Provider Demographics
NPI:1093922189
Name:CHARLES RIVER ENDOSCOPY LLC
Entity Type:Organization
Organization Name:CHARLES RIVER ENDOSCOPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VINAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-881-3029
Mailing Address - Street 1:171 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1187
Mailing Address - Country:US
Mailing Address - Phone:508-881-3029
Mailing Address - Fax:508-881-1752
Practice Address - Street 1:297 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6337
Practice Address - Country:US
Practice Address - Phone:508-665-4110
Practice Address - Fax:508-665-4111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARTNERS COMMUNITY HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-17
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy