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Organization

BAYSTATE MEDICAL PRACTICES, INC

Active
Parent organization
BAYSTATE MEDICAL PRACTICES, INC
Other names
BMP, Dept of Emergency Dept.
Organization subpart
Yes

Provider details

NPI number
Legal business name
BAYSTATE MEDICAL PRACTICES, INC
Authorized official
RANDALL L VAILL JR. (MANAGER PROVIDER ENROLLMENT)
(413) 794-7976
Entity
Organization

Contact information

Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
(413) 794-5700
(413) 794-1629
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
(413) 794-1629

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
207Q00000X
Family Medicine Physician

Other

Enumeration date
12/29/2006
Last updated
02/26/2014
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