Provider Demographics
NPI:1902863434
Name:ALLCARE MEDICAL SUPPLY CORPORATION
Entity Type:Organization
Organization Name:ALLCARE MEDICAL SUPPLY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREDERICKS
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:508-865-4857
Mailing Address - Street 1:30 GRAFTON ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-3918
Mailing Address - Country:US
Mailing Address - Phone:508-865-4857
Mailing Address - Fax:508-865-6370
Practice Address - Street 1:30 GRAFTON ST
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-3918
Practice Address - Country:US
Practice Address - Phone:508-865-4857
Practice Address - Fax:508-865-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000390754OtherBLUE CROSS BLUE SHIELD
MA043506593-00OtherNEIGHBORHOOD HEALTH PLAN
MA000000024226OtherBMC HEALTHNET
MA967611OtherNETWORK HEALTH
MA1539370Medicaid
5810860001Medicare NSC