Provider Demographics
NPI:1679598460
Name:STURDY MEMORIAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:STURDY MEMORIAL ASSOCIATES, INC.
Other - Org Name:REHOBOTH SEEKONK 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 1:538 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1227
Mailing Address - Country:US
Mailing Address - Phone:508-336-9200
Mailing Address - Fax:508-336-9303
Practice Address - Street 1:538 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-1227
Practice Address - Country:US
Practice Address - Phone:508-336-9200
Practice Address - Fax:508-336-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA615462OtherTUFTS
MA9775145Medicaid
MA334OtherFALLON
MAM16601OtherBCBS MA
MA334OtherFALLON
MA=========-006OtherTRICARE
MA=========-0117OtherMASS REHAB