Provider Demographics
NPI:1801075080
Name:HOLBROOK BOARD OF HEALTH
Entity type:Organization
Organization Name:HOLBROOK BOARD OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH AGENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-767-3030
Mailing Address - Street 1:50 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-1560
Mailing Address - Country:US
Mailing Address - Phone:781-767-3030
Mailing Address - Fax:781-767-9562
Practice Address - Street 1:50 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-1560
Practice Address - Country:US
Practice Address - Phone:781-767-3030
Practice Address - Fax:781-767-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11021Medicare UPIN