Provider Demographics
NPI:1689006322
Name:WESTFIELD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:WESTFIELD MEDICAL CORPORATION
Other - Org Name:NOBLE EXPRESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-568-2811
Mailing Address - Street 1:115 W SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3678
Mailing Address - Country:US
Mailing Address - Phone:413-562-3444
Mailing Address - Fax:413-572-5016
Practice Address - Street 1:57 UNION ST, STE 101
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-2658
Practice Address - Country:US
Practice Address - Phone:413-642-7200
Practice Address - Fax:413-562-1821
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTFIELD MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9782265Medicaid
MAM20759OtherMEDICARE GROUP #