Provider Demographics
NPI:1932541729
Name:PUBLIC PARTNERSHIPS LLC
Entity Type:Organization
Organization Name:PUBLIC PARTNERSHIPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:H
Authorized Official - Last Name:FENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-426-2026
Mailing Address - Street 1:40 BROAD ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4316
Mailing Address - Country:US
Mailing Address - Phone:617-426-2026
Mailing Address - Fax:617-717-1784
Practice Address - Street 1:40 BROAD ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4316
Practice Address - Country:US
Practice Address - Phone:617-426-2026
Practice Address - Fax:617-717-1784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1417262056Medicaid