Provider Demographics
NPI:1770027492
Name:BENJAMIN, RONALD
Entity Type:Organization
Organization Name:BENJAMIN, RONALD
Other - Org Name:COMWELL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:617-460-7494
Mailing Address - Street 1:172 CUSHING ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4582
Mailing Address - Country:US
Mailing Address - Phone:617-460-7494
Mailing Address - Fax:858-309-3397
Practice Address - Street 1:172 CUSHING ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4582
Practice Address - Country:US
Practice Address - Phone:617-460-7494
Practice Address - Fax:858-309-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health