Agawam Nursing LLC
Organization Active NPI Skilled Nursing Facility · Agawam, MA
NPI 1992784037 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1992784037
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0967 (MA)
- Legal business name
- AGAWAM NURSING LLC
- Practice address
- 1200 Suffield St
Agawam, MA 01001-2933 - Phone
- (413) 789-2200
- NPI assigned
- Jan 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Brad Rolph
- Title
- Cfo
- Phone
- (781) 297-8626
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0967 | MA | Yes |
Addresses
Primary practice location
1200 Suffield St
Agawam, MA 01001-2933
Mailing address
50 Kerry PL
Norwood, MA 02062-4775
Phone (781) 619-0250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0926744 | Medicaid | MA |
Other names
- Country Estates of Agawam
Other providers in Agawam, MA
- Adaptive Prosthetics & Orthotics LLC
- Paulo Afonso
- Agawam East Rehab and Nursing LLC
- Agawam Medical Supply Corp
- Agawam North Rehab and Nursing LLC
- Agawam South Rehab and Nursing LLC
- Agawam West Rehab and Nursing LLC
- Danielle Leigh Allard
- Am Medical PC
- Heidi Lee Amaral
All providers in Agawam, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.