Provider Demographics
NPI:1770792673
Name:BERKSHIRE CARE INC
Entity type:Organization
Organization Name:BERKSHIRE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOAMS
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:MCNULTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-442-1571
Mailing Address - Street 1:276 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6835
Mailing Address - Country:US
Mailing Address - Phone:413-442-1571
Mailing Address - Fax:413-443-3567
Practice Address - Street 1:276 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6835
Practice Address - Country:US
Practice Address - Phone:413-442-1571
Practice Address - Fax:413-443-3567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44382207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2073404Medicaid
MA2073404Medicaid
MAI22262Medicare ID - Type Unspecified