Provider Demographics
NPI:1427213321
Name:MASSCAL MEDICAL SUPPLY
Entity Type:Organization
Organization Name:MASSCAL MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-855-4196
Mailing Address - Street 1:23 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1711
Mailing Address - Country:US
Mailing Address - Phone:978-855-4196
Mailing Address - Fax:
Practice Address - Street 1:23 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-1711
Practice Address - Country:US
Practice Address - Phone:978-855-4196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
N/AOtherDO NOT HAVE ANY STATE OR FEDERAL LISCENCES AT THIS TIME