Provider Demographics
NPI:1497771703
Name:STURDY MEMORIAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:STURDY MEMORIAL ASSOCIATES, INC.
Other - Org Name:NORTH ATTLEBOROUGH MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHYAVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-236-8000
Mailing Address - Street 1:170 DRAPER AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3604
Mailing Address - Country:US
Mailing Address - Phone:508-699-6100
Mailing Address - Fax:508-695-1341
Practice Address - Street 1:170 DRAPER AVE
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-3604
Practice Address - Country:US
Practice Address - Phone:508-699-6100
Practice Address - Fax:508-695-1341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA325OtherFALLON
MAM13252OtherMABC
MA9758224Medicaid
MA728867OtherTUFTS
MA=========-001OtherTRICARE
MA9758224Medicaid
MAM13252OtherMABC