Provider Demographics
NPI:1194023044
Name:HUNGRY HILL FAMILY PRACTICE
Entity Type:Organization
Organization Name:HUNGRY HILL FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN,F.N.P.,B.C.
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:V
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:413-273-1638
Mailing Address - Street 1:776 LIBERTY STREET
Mailing Address - Street 2:HUNGRY HILL FAMILY PRACTICE
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-273-1638
Mailing Address - Fax:413-273-1410
Practice Address - Street 1:776 LIBERTY STREET
Practice Address - Street 2:HUNGRY HILL FAMILY PRACTICE
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104
Practice Address - Country:US
Practice Address - Phone:413-273-1638
Practice Address - Fax:413-273-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187756261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center