Provider Demographics
NPI:1184679722
Name:PLANNED PARENTHOOD LEAGUE OF MA
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD LEAGUE OF MA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP COO
Authorized Official - Prefix:
Authorized Official - First Name:MEAGON
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-616-1660
Mailing Address - Street 1:1055 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:KAREN LOEB LIFFORD MD
Practice Address - Street 2:631 LINCOLN ST
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-854-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4174332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
2241379OtherOTHER ID NUMBER-COMMERCIAL NUMBER