| Leominster Community Health Connections | |
|
14 Manning Avenue Leominster MA 01453-5768 | |
| (978) 847-0110 | |
| (978) 847-0112 |
| Full Name | Leominster Community Health Connections |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Manning Avenue, Leominster, Massachusetts |
| Authorized Official Name and Position | John A Demalia (PRESIDENT AND CEO) |
| Authorized Official Contact | 9788788510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leominster Community Health Connections 326 Nichols Road Fitchburg MA 01420-1914 Ph: (978) 878-8100 | Leominster Community Health Connections 14 Manning Avenue Leominster MA 01453-5768 Ph: (978) 847-0110 |
| NPI Number | 1891953048 |
|---|---|
| Provider Enumeration Date | 05/23/2008 |
| Last Update Date | 08/24/2022 |
| Medicare PECOS PAC ID | 8729074992 |
|---|---|
| Medicare Enrollment ID | O20090220000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891953048 | NPI | - | NPPES |
| 1304780 | Medicaid | MA | |
| M21400 | Other | MA | MEDICARE |
| 221893 | Other | WI | MEDICARE UGS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Massachusetts) | Primary |
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