Provider Demographics
NPI:1184883282
Name:WESTFIELD MEADOWS CORPORATION
Entity type:Organization
Organization Name:WESTFIELD MEADOWS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-562-6940
Mailing Address - Street 1:1555 ORLEANS RD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2145
Mailing Address - Country:US
Mailing Address - Phone:508-430-1851
Mailing Address - Fax:508-430-1862
Practice Address - Street 1:74 OLD HOLYOKE RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1487
Practice Address - Country:US
Practice Address - Phone:413-562-6940
Practice Address - Fax:413-564-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1900048Medicaid