Masonicare Health Center
LBN: Masonicare Health Center
Masonicare Health Center is an health care organization with primary practice located at 22 Masonic Ave , Wallingford CT 06492-3048. The organization recently has 4 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Ambulatory Surgical, Ambulatory Health Care Facilities / Community Health, Suppliers / Prosthetic/Orthotic Supplier. Ambulatory Health Care Facilities / Ambulatory Surgical is the primary health care specialty.
Masonicare Health Center can be contacted via phone (203) 679-5900, or through Venoit, Jon-Paul via phone (203) 679-5000.
Contact Information
Primary practice address
22 Masonic Ave
Wallingford CT 06492-3048
Phone: (203) 679-5900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | 0075 | Connecticut |
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 0075 | Connecticut |
| Ambulatory Health Care Facilities / Community Health | 261QC1500X | 0075 | Connecticut |
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | 0075 | Connecticut |
Profile Details
| NPI number | 1588638688 |
|---|---|
| LBN Legal business name | Masonicare Health Center |
| DBA Doing business as | |
| Authorized official | Venoit, Jon-Paul |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Nov 5th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588638688 | NPPES |
| Connecticut | MEDICAID | 004025425 | |
| Connecticut | MEDICAID | 0070177 | |
| Connecticut | Other | 082 | |
| Connecticut | MEDICAID | 004014791 |
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