Provider Demographics
NPI:1780646927
Name:BRIMFIELD FAMILY HEALTH CENTER, P.C.
Entity Type:Organization
Organization Name:BRIMFIELD FAMILY HEALTH CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:413-245-3389
Mailing Address - Street 1:255 E OLD STURBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRIMFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01010-9647
Mailing Address - Country:US
Mailing Address - Phone:413-245-3389
Mailing Address - Fax:413-245-4553
Practice Address - Street 1:255 E OLD STURBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRIMFIELD
Practice Address - State:MA
Practice Address - Zip Code:01010-9647
Practice Address - Country:US
Practice Address - Phone:413-245-3389
Practice Address - Fax:413-245-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9731079Medicaid
MAM14798Medicare ID - Type Unspecified