Provider Demographics
NPI: | 1972330165 |
---|---|
Name: | LIFESPAN OF MASSACHUSETTS - FALL RIVER INC |
Entity type: | Organization |
Organization Name: | LIFESPAN OF MASSACHUSETTS - FALL RIVER INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SVP, FINANCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EVA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GREENWOOD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 401-444-7284 |
Mailing Address - Street 1: | 117 ELLENFIELD ST STE 101 |
Mailing Address - Street 2: | |
Mailing Address - City: | PROVIDENCE |
Mailing Address - State: | RI |
Mailing Address - Zip Code: | 02905-4541 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 401-444-6779 |
Mailing Address - Fax: | 401-444-6912 |
Practice Address - Street 1: | 795 MIDDLE ST |
Practice Address - Street 2: | |
Practice Address - City: | FALL RIVER |
Practice Address - State: | MA |
Practice Address - Zip Code: | 02721-1733 |
Practice Address - Country: | US |
Practice Address - Phone: | 508-674-5600 |
Practice Address - Fax: | 617-562-7241 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-09-19 |
Last Update Date: | 2025-04-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty | |
No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
No | 273R00000X | Hospital Units | Psychiatric Unit | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |