North Shore Preventive Health Care, P.c. | |
75 Herrick St Suite 116 Beverly MA 01915-5903 | |
(978) 502-8850 | |
Not Available |
Full Name | North Shore Preventive Health Care, P.c. |
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Speciality | Internal Medicine |
Location | 75 Herrick St, Beverly, Massachusetts |
Authorized Official Name and Position | Roy Leland Ruff (PRESIDENT) |
Authorized Official Contact | 9785028850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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North Shore Preventive Health Care, P.c. 75 Herrick St Suite 116 Beverly MA 01915-5903 Ph: (978) 502-8850 | North Shore Preventive Health Care, P.c. 75 Herrick St Suite 116 Beverly MA 01915-5903 Ph: (978) 502-8850 |
NPI Number | 1255691556 |
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Provider Enumeration Date | 05/21/2012 |
Last Update Date | 05/21/2012 |
Medicare PECOS PAC ID | 9537325907 |
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Medicare Enrollment ID | O20120730000703 |
Identifier | Type | State | Issuer |
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1255691556 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 45310 (Massachusetts) | Primary |
207RP1001X | Internal Medicine - Pulmonary Disease | 45310 (Massachusetts) | Secondary |
Provider Name | Roy L Ruff |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326072661 PECOS PAC ID: 1951341965 Enrollment ID: I20051024000937 |
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