Provider Demographics
NPI:1659406213
Name:SURGI-CARE, INC
Entity Type:Organization
Organization Name:SURGI-CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DILIDDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-290-1807
Mailing Address - Street 1:71 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1105
Mailing Address - Country:US
Mailing Address - Phone:800-797-8744
Mailing Address - Fax:800-338-6304
Practice Address - Street 1:150 DOTY CIR
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1310
Practice Address - Country:US
Practice Address - Phone:413-746-8950
Practice Address - Fax:413-746-9037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURGI-CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-23
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332B0000X332B00000X
MA335E00000X335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA304954OtherBCBS OF MA
MA1530691Medicaid
MA700756OtherHARVARD
MA801559OtherTUFTS
MA000000021644OtherBMC HEALTHNET PLAN
MA2250383OtherCIGNA
MA304954OtherBCBS OF MA
MA1530691Medicaid
MA000000021644OtherBMC HEALTHNET PLAN
MA801559OtherTUFTS