Signature Medical Group

LBN: Bridgewater Goddard Park Medical Associates, Inc.
Signature Medical Group is an health care organization with primary practice located at 110 Liberty St , Brockton MA 02301-5521. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Bridgewater Goddard Park Medical Associates, Inc. can be contacted via phone (508) 894-0400, or through Hollon, Kim via phone (508) 941-7004.

Contact Information

Primary practice address
110 Liberty St Brockton MA 02301-5521
Phone: (508) 894-0400
Fax: (508) 565-0157
Website:
Map and Directions
Authorized official contact:
Name: Hollon, Kim
Phone: (508) 941-7004

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1417932591
LBN Legal business name Bridgewater Goddard Park Medical Associates, Inc.
DBA Doing business as Signature Medical Group
Authorized official Hollon, Kim
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2005
Last updated Jun 18th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417932591 NPPES
Massachusetts MEDICAID 110022141E

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