Organization
DERIVIERE MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WICHNITE DERIVIERE RN (PRESIDENT)
(617) 596-1947
Entity
Organization
Contact information
Practice address
156 HIGHLAND AVE, SOMERVILLE, MA 02143-1534
(617) 623-1732
(617) 628-0753
Mailing address
156 HIGHLAND AVE, SOMERVILLE, MA 02143-1534
(617) 623-1732
(617) 628-0753
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
202190
MA
251E00000X
Home Health Agency
202190
MA
251G00000X
Community Based Hospice Care Agency
202190
MA
251J00000X
Nursing Care Agency
Primary
202190
MA
Other
Enumeration date
04/16/2009
Last updated
04/16/2009
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