Provider Demographics
NPI:1649334269
Name:UMASS MEMORIAL MEDICAL CENTER
Entity type:Organization
Organization Name:UMASS MEMORIAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:HUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:508-265-4926
Mailing Address - Street 1:37 AMHERST ST
Mailing Address - Street 2:APT #3
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-2009
Mailing Address - Country:US
Mailing Address - Phone:508-265-4926
Mailing Address - Fax:
Practice Address - Street 1:37 AMHERST ST
Practice Address - Street 2:APT #3
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2009
Practice Address - Country:US
Practice Address - Phone:508-265-4926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226681282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital