Provider Demographics
NPI:1013080043
Name:SOUTH HADLEY BOARD OF HEALTH
Entity Type:Organization
Organization Name:SOUTH HADLEY BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-538-5013
Mailing Address - Street 1:116 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-2833
Mailing Address - Country:US
Mailing Address - Phone:413-538-5013
Mailing Address - Fax:413-538-5012
Practice Address - Street 1:116 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-2833
Practice Address - Country:US
Practice Address - Phone:413-538-5013
Practice Address - Fax:413-538-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42642251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11056Medicare ID - Type Unspecified