Provider Demographics
NPI:1881765733
Name:PHILANTHROPIC ASSOC. OF SWANSEA, INC
Entity type:Organization
Organization Name:PHILANTHROPIC ASSOC. OF SWANSEA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SOARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-675-2399
Mailing Address - Street 1:285 WILBUR AVENUE
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777
Mailing Address - Country:US
Mailing Address - Phone:508-675-2399
Mailing Address - Fax:508-646-1726
Practice Address - Street 1:285 WILBUR AVENUE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777
Practice Address - Country:US
Practice Address - Phone:508-675-2399
Practice Address - Fax:508-646-1726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31503416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA802294OtherTUFTS HEALTHCARE
CTA1285348OtherOXFORD HEALTH PLANS
SCSO22040OtherTRI-CARE MGS
MA0019059OtherNEIGHBORHOOD HEALTH
RI201761OtherRI BLUE CHIP
PA0081217OtherUS HEALTHCARE
MA017059OtherMASS BLUE CROSS
MA700110OtherHARVARD-PILGRIM
MA1700855OtherMASS HEALTH CARE
RI9996-5OtherRI BLUE CROSS
MA25097OtherBOSTON MEDICAL CENTER
MA1700855Medicaid
RI2017610AOtherHMO OF RI
RISA05381OtherRI EDS
RISA05381OtherRI EDS