Provider Demographics
NPI:1255506325
Name:ST ANNE'S HOSPITAL
Entity Type:Organization
Organization Name:ST ANNE'S HOSPITAL
Other - Org Name:MILLVIEW MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONCAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-235-5445
Mailing Address - Street 1:191 BEDFORD ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3011
Mailing Address - Country:US
Mailing Address - Phone:508-235-5445
Mailing Address - Fax:
Practice Address - Street 1:191 BEDFORD ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3011
Practice Address - Country:US
Practice Address - Phone:508-235-5445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234513207Q00000X
MA150167207R00000X
MA234927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG22622Medicare UPIN
MAA2101201Medicare PIN
MA220020Medicare PIN