Provider Demographics
NPI:1982153524
Name:MCGOVERN, EDMUND
Entity Type:Individual
Prefix:
First Name:EDMUND
Middle Name:
Last Name:MCGOVERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-0344
Mailing Address - Country:US
Mailing Address - Phone:978-251-3938
Mailing Address - Fax:978-251-0758
Practice Address - Street 1:63 MIDDLESEX ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1583
Practice Address - Country:US
Practice Address - Phone:978-251-3938
Practice Address - Fax:978-251-0758
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide