NPIMap

Organization Active NPI

Hollywell Healthcare, LLC

  • Skilled Nursing Facility
  • Randolph, MA
National Provider Identifier
1871540070
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0439 Issued in MA
Legal business name
HOLLYWELL HEALTHCARE, LLC
Practice address
975 N Main St
Randolph, MA 02368-3056
Phone
(781) 963-8800
Fax
(781) 963-8922
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Joseph Veno
Title
Auth. Person/Administrator
Phone
(781) 963-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0439 MA Primary

Addresses

Primary practice location

975 N Main St
Randolph, MA 02368-3056

Mailing address

975 N Main St
Randolph, MA 02368-3056
Phone (781) 963-8800

Other identifiers 1

IdentifierTypeStateIssuer
0928801MedicaidMA

Other names 1

  • Hollywell Doing business as

National Provider Directory

National Provider Directory

Locations

975 N Main St
Randolph, MA 02368
Phone (781) 963-8800

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871540070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683056",
            "telephone_number": "781-963-8800",
            "fax_number": "781-963-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683056",
            "telephone_number": "781-963-8800",
            "fax_number": "781-963-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWELL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VENO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "AUTH. PERSON/ADMINISTRATOR",
        "authorized_official_telephone_number": "781-963-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0928801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollywell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.