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 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Community Health, Hospitals / Chronic Disease Hospital. Hospitals / Chronic Disease Hospital 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
Fax:
Website:
Authorized official contact:
Name: Venoit, Jon-Paul

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Community Health 261QC1500X 0075 Connecticut
Hospitals / Chronic Disease Hospital 281P00000X 11CD Connecticut

Profile Details

NPI number 1629061593
LBN Legal business name Masonicare Health Center
DBA Doing business as
Authorized official Venoit, Jon-Paul
Entity Organization
Organization subpart 1 No
Enumeration date Aug 25th, 2005
Last updated Nov 5th, 2019 - about 5 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 1629061593 NPPES
Connecticut MEDICAID 004025425
Connecticut Other 082
Connecticut MEDICAID 000070177

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