Organization
FALLON COMMUNITY HEALTH PLAN
Active
Other names
Summit ElderCareSM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES GOHEEN (CHIEF FINANCIAL OFFICER)
(508) 368-9499
Entity
Organization
Contact information
Practice address
277 E MOUNTAIN ST, WORCESTER, MA 01606-1207
(508) 852-2026
(508) 856-7130
Mailing address
10 CHESTNUT ST, WORCESTER, MA 01608-2898
(508) 368-9437
(508) 754-1931
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
1803247
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1803247
—
MA
Enumeration date
01/19/2007
Last updated
08/22/2020
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