Organization
BAYSTATE WING HOSPITAL CORPORATION
Active
Parent organization
BAYSTATE WING HOSPITAL CORPORATION
Other names
Baystate Wing Hospital: Visiting Nurse Association & Hospice
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYSTATE WING HOSPITAL CORPORATION
Authorized official
KEARY T ALLICON (TREASURER & CFO)
(413) 284-5302
Entity
Organization
Contact information
Practice address
4 SPRINGFIELD ST., BLDG. 3, 4TH FL., THREE RIVERS, MA 01080-1242
(413) 283-9715
(413) 283-8084
Mailing address
40 WRIGHT ST, PALMER, MA 01069-1138
(413) 283-9715
(413) 283-8084
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2181
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0608157
—
MA
01
—
221515
MA BLUECROSSBLUESHIELD
MA
01
—
804993
TUFTS HEALTH PLAN
—
01
—
981443
NETWORK HEALTH
—
Enumeration date
02/13/2007
Last updated
10/31/2014
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