Provider Demographics
NPI:1356682868
Name:AMESBURY ANIMAL HOSPITAL
Entity Type:Organization
Organization Name:AMESBURY ANIMAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BASTIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:978-388-3636
Mailing Address - Street 1:230 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3615
Mailing Address - Country:US
Mailing Address - Phone:978-388-3636
Mailing Address - Fax:978-388-7855
Practice Address - Street 1:230 MAIN ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3615
Practice Address - Country:US
Practice Address - Phone:978-388-3636
Practice Address - Fax:978-388-7855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4271284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital