Vineyard Personalized Medicine LLC
General Practice in West Tisbury, Massachusetts
1275894875- Practice location
- 24 Cournoyer RD, West Tisbury, MA 02575
- Phone
- 508-693-1300
- Fax
- 508-693-1305
- Last updated
- November 25, 2015
Vineyard Personalized Medicine LLC is a healthcare organization based in West Tisbury, MA. Vineyard Personalized Medicine LLC practices in West Tisbury, MA. The NPI Number for Vineyard Personalized Medicine LLC is 1275894875 and holds a License No. 72590 (MA). The current practice location address for Vineyard Personalized Medicine LLC is 24 Cournoyer RD, West Tisbury, MA 02575 and can be reached out via phone at 508-693-1300 and via fax at 508-693-1305.
Provider Profile Details
- NPI Number
- 1275894875
- Provider Name
- Vineyard Personalized Medicine LLC
- Provider Entity Type
- Organization
- Address
- 24 Cournoyer RD, West Tisbury, MA 02575
- Phone Number
- 508-693-1300
- Fax Number
- 508-693-1305
- Primary Taxonomy
- General Practice · 208D00000X
- Organization Subpart
- No
- Authorized Official
- Lisa Nagy, MD · Sole Proprietor · 508-693-1300
- Other Names
- Environmental Health Center Of Martha'S Vineyard (Doing Business As)
- Provider Enumeration Date
- May 31, 2012
- Last Update Date
- November 25, 2015
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 24 Cournoyer RD
West Tisbury, MA 02575 - City
- West Tisbury
- State
- Massachusetts
- Zip
- 02575
- Phone Number
- 508-693-1300
- Fax Number
- 508-693-1305
Provider Business Mailing Address Details
- Address
- 24 Cournoyer RD
Vineyard Haven, MA 02568-7625 - City
- Vineyard Haven
- State
- MA
- Zip
- 02568-7625
- Phone Number
- 508-693-1300
- Fax Number
- 508-693-1305
License Information
- License Number
- 72590
- License State
- MA
- Taxonomy
- General Practice · 208D00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Vineyard Personalized Medicine LLC?
The NPI number of Vineyard Personalized Medicine LLC is 1275894875. It was assigned on May 31, 2012 and is currently active in the NPPES registry.
What is the specialty of Vineyard Personalized Medicine LLC?
Vineyard Personalized Medicine LLC is registered under the primary taxonomy General Practice (code 208D00000X), licensed in MA under license number 72590.
Where does Vineyard Personalized Medicine LLC practice?
The practice location is 24 Cournoyer RD, West Tisbury, MA 02575. The office can be reached at 508-693-1300 (phone) or 508-693-1305 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1275894875 directly on the NPPES registry website.