Provider Demographics
NPI:1629586565
Name:NASHOBA VALLEY MEDICAL CENTER, A STEWARD FAMILY HOSPITAL, INC
Entity Type:Organization
Organization Name:NASHOBA VALLEY MEDICAL CENTER, A STEWARD FAMILY HOSPITAL, INC
Other - Org Name:NASHOBA VALLEY MEDICAL CENTER BEHAVIORAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:CORP DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-375-3308
Mailing Address - Street 1:30 PERWAL ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1928
Mailing Address - Country:US
Mailing Address - Phone:781-375-3308
Mailing Address - Fax:
Practice Address - Street 1:200 GROTON RD
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1168
Practice Address - Country:US
Practice Address - Phone:978-784-9238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEWARD HEALTH CARE SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
MA2298282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty