Medford Healthcare Group, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0842 Issued in MA

Legal business name

MEDFORD HEALTHCARE GROUP, LLC

Practice address

300 Winthrop St
Medford, MA 02155-2311

Phone

(781) 396-4400

Fax

(781) 396-8348

NPI assigned

Mar 21, 2011

Organization subpart

Yes

Parent organization

SABER HEALTHCARE HOLDINGS, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William I Weisberg

Title

Vice President

Phone

(216) 292-5706

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1013216738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 RICHMOND RD",
            "city": "BEDFORD HEIGHTS",
            "state": "OH",
            "postal_code": "441461421",
            "telephone_number": "216-292-5706",
            "fax_number": "216-292-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WINTHROP ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021552311",
            "telephone_number": "781-396-4400",
            "fax_number": "781-396-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD HEALTHCARE GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SABER HEALTHCARE HOLDINGS, LLC",
        "enumeration_date": "2011-03-21",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "216-292-5706"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110090142A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medford Endodontics, LLC
• Medford Eyecare LLC
• Medford Eyeglass Shop Inc.
• Medford Family & Cosmetic Dentistry PLLC
• Medford Family Dental Care
• Medford Main Street Dental P.C.
• Medford Medical Laboratory Inc.
• Medford Optical Shop, Inc.
• Medford Square Dentistry and Implants LLC
• Medford Surgery Center LLC

• Skilled Nursing Facility in Medford, MA
• Providers in Medford, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.