| Flying High Farm, Inc | |
|
615 Leominster Rd Lunenburg MA 01462-2013 | |
| (978) 582-7103 | |
| (775) 582-7103 |
| Full Name | Flying High Farm, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 615 Leominster Rd, Lunenburg, Massachusetts |
| Authorized Official Name and Position | Christine Randle (PRESIDENT) |
| Authorized Official Contact | 9785827103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Flying High Farm, Inc 615 Leominster Rd Lunenburg MA 01462-2013 Ph: (978) 582-7103 | Flying High Farm, Inc 615 Leominster Rd Lunenburg MA 01462-2013 Ph: (978) 582-7103 |
| NPI Number | 1598954539 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 10/16/2007 |
| Medicare PECOS PAC ID | 4880978865 |
|---|---|
| Medicare Enrollment ID | O20170313000962 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598954539 | NPI | - | NPPES |
| 1081760 | Other | MA | FALLON |
| P10415 | Other | MA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 111274 (Massachusetts) | Primary |
| Provider Name | Christine L Randle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588765473 PECOS PAC ID: 1052343373 Enrollment ID: I20050908000112 |
| Provider Name | Pamela D Carey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982616413 PECOS PAC ID: 3971889957 Enrollment ID: I20170405000682 |
| Provider Name | Sarah M Charest Dubovsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558543603 PECOS PAC ID: 7719263078 Enrollment ID: I20170421000406 |
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