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Contact Information

CLEANSLATE MEDICAL GROUP OF THE DISTRICT OF COLUMBIA PLLC
244 MAIN ST
NORTHAMPTON, MA01060
 Phone: 413-584-2173
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CLEANSLATE MEDICAL GROUP OF THE DISTRICT OF COLUMBIA PLLC

NPI # 1194264911
LBN Legal business name CLEANSLATE MEDICAL GROUP OF THE DISTRICT OF COLUMBIA PLLC
Authorized official PATRICK MURPHY - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/13/2017
Last updated 02/13/2017 - About 9 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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