Provider Demographics
NPI:1164427431
Name:ESSENT HEALTHCARE - AYER, INC.
Entity Type:Organization
Organization Name:ESSENT HEALTHCARE - AYER, INC.
Other - Org Name:NASHOBA VALLEY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-312-5106
Mailing Address - Street 1:200 GROTON RD
Mailing Address - Street 2:
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1168
Mailing Address - Country:US
Mailing Address - Phone:978-784-9000
Mailing Address - Fax:
Practice Address - Street 1:200 GROTON RD
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1168
Practice Address - Country:US
Practice Address - Phone:978-784-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESSENT HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-14
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2298282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2222009810OtherBLUE CROSS OUTPATIENT
MA2222009801OtherBLUE CROSS INPATIENT
M21244OtherMEDICARE PART B
903837OtherHARVARD PILGRIM HC
136598CFOtherPREFERRED CARE
974225OtherNETWORK HEALTH
982010OtherTUFTS OUTPATIENT
MA1001311Medicaid
MA1213270Medicaid
6300130OtherAETNA US HEALTHCARE
982011OtherTUFTS INPATIENT
MA1213270Medicaid