Provider Demographics
NPI:1639374028
Name:NORTHAMPTON HEALTHCARE ASSOC
Entity type:Organization
Organization Name:NORTHAMPTON HEALTHCARE ASSOC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMASTRIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-586-3300
Mailing Address - Street 1:737 BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-1526
Mailing Address - Country:US
Mailing Address - Phone:413-586-3300
Mailing Address - Fax:
Practice Address - Street 1:737 BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-1526
Practice Address - Country:US
Practice Address - Phone:413-586-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07753140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA225381Medicare ID - Type Unspecified