National Provider Identifier Database

FEDERAL MEDICAL CENTER DEVENS
Prison Health


Contact Information

FEDERAL MEDICAL CENTER DEVENS
42 PATTON RD
AYER, MA01433
Phone: 978-796-1400
Fax:
Website:
Specialty Taxonomy Code
* Prison Health 261QP2400X

* Indicates primary specialty

NPI Profile & details for FEDERAL MEDICAL CENTER DEVENS

NPI Number 1295046647
Legal business name
LBN
FEDERAL MEDICAL CENTER DEVENS
Authorized official ALBERTO BETANCES - (ASSIST HEALTH SERVICE ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 06/30/2010
Last updated 06/30/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • MA License #: PA2382
  • MA Other: PA2382 STATE PHYSICIAN ASSISTANT LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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