Provider Demographics
NPI:1922031517
Name:NWB CORPORATION
Entity Type:Organization
Organization Name:NWB CORPORATION
Other - Org Name:PORT HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARCIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-556-5900
Mailing Address - Street 1:25 RAILROAD SQ
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-5721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3540
Practice Address - Country:US
Practice Address - Phone:978-462-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0856314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0913634Medicaid
MA694422OtherAETNA US HEALTHCARE
MA801498OtherTUFTS
MA902998OtherHARVARD PILGRIM
MA70012222527101OtherBCBS OF MA
MA7101239OtherEVERCARE
MA694422OtherAETNA\US HEALTHCARE
MA801498OtherTUFTS
MA902998OtherHARVARD PILGRIM