Provider Demographics
NPI:1932612132
Name:COLUMN HEALTH LLC
Entity Type:Organization
Organization Name:COLUMN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-710-6488
Mailing Address - Street 1:339 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-6718
Mailing Address - Country:US
Mailing Address - Phone:617-710-6488
Mailing Address - Fax:
Practice Address - Street 1:339 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6718
Practice Address - Country:US
Practice Address - Phone:617-710-6488
Practice Address - Fax:617-710-6488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
S100205721OtherMEDICARE
MA1861898934OtherNPI
MA110102199AMedicaid