Provider Demographics
NPI:1659522027
Name:CARITAS VALLEY REGIONAL SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:CARITAS VALLEY REGIONAL SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDRURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-687-0156
Mailing Address - Street 1:70 EAST ST
Mailing Address - Street 2:ATTN: MARTHA MCDRURY
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4597
Mailing Address - Country:US
Mailing Address - Phone:978-687-0156
Mailing Address - Fax:978-685-9132
Practice Address - Street 1:70 EAST ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4597
Practice Address - Country:US
Practice Address - Phone:978-687-0156
Practice Address - Fax:978-685-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty