Organization
COMMONWEALTH CARE ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY ANN VINCUILLA R.N. (REGISTERED NURSE)
(508) 561-0067
Entity
Organization
Contact information
Practice address
529 MAIN ST, SUITE 216, CHARLESTOWN, MA 02129-1125
(617) 600-3195
Mailing address
39 ORIOLE DR, NORTH ATTLEBORO, MA 02760-2726
(508) 561-0067
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
RN211669
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN211669
RN LICENSE
MA
Enumeration date
03/04/2016
Last updated
03/04/2016
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