Provider Demographics
NPI:1306209382
Name:UMS LITHOTRIPSY SERVICES OF CENTRAL MASSACHUSETTS, LLC
Entity Type:Organization
Organization Name:UMS LITHOTRIPSY SERVICES OF CENTRAL MASSACHUSETTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TALEBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-955-4923
Mailing Address - Street 1:1700 W PARK DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3939
Mailing Address - Country:US
Mailing Address - Phone:703-955-4923
Mailing Address - Fax:571-313-0262
Practice Address - Street 1:1700 W PARK DR
Practice Address - Street 2:SUITE 410
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3939
Practice Address - Country:US
Practice Address - Phone:703-955-4923
Practice Address - Fax:571-313-0262
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED MEDICAL SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-29
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QL0400XAmbulatory Health Care FacilitiesClinic/CenterLithotripsy