Provider Demographics
NPI:1972253516
Name:PRIVATE HEALTH HUB LLC
Entity Type:Organization
Organization Name:PRIVATE HEALTH HUB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAGADDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-296-5444
Mailing Address - Street 1:PO BOX 541157
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02454-1157
Mailing Address - Country:US
Mailing Address - Phone:781-312-5450
Mailing Address - Fax:
Practice Address - Street 1:267 MOODY ST STE 207
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5238
Practice Address - Country:US
Practice Address - Phone:781-312-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health