Organization
HAWTHORN ENDOSCOPY SERVICE, LLC
Active
Other names
Hawthorn Ambulatory Services
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GULAREK (CEO)
(508) 996-3991
Entity
Organization
Contact information
Practice address
535 FAUNCE CORNER ROAD, NORTH DARTMOUTH, MA 02747-3717
(508) 996-3991
Mailing address
PO BOX 3076, BOSTON, MA 02241-3076
(508) 996-3991
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
806282
TUFTS HEALTH PLAN
MA
01
—
M88022
BLUE CROSS
MA
Enumeration date
03/23/2006
Last updated
07/13/2009
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