Organization
CONSOLIDATED HEALTH PLAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA A SHIVELY (PROVIDER RELATIONS SUPERVISOR)
(413) 733-4540
Entity
Organization
Contact information
Practice address
2077 ROOSEVELT AVE, SPRINGFIELD, MA 01104-1657
(413) 733-4540
(413) 781-1958
Mailing address
2077 ROOSEVELT AVE, SPRINGFIELD, MA 01104-1657
(413) 733-4540
(413) 781-1958
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
MA
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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