Basic Information
| Provider Information | |||||||||
| NPI: | 1023680824 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MASS WELLNESS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 675 PARAMOUNT DR STE 205A | ||||||||
| Address2: | |||||||||
| City: | RAYNHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027675416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178335626 | ||||||||
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| Practice Location | |||||||||
| Address1: | 675 PARAMOUNT DR STE 205A | ||||||||
| Address2: | |||||||||
| City: | RAYNHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027675416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178335626 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2021 | ||||||||
| LastUpdateDate: | 07/13/2021 | ||||||||
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| AuthorizedOfficialLastName: | HINEDI | ||||||||
| AuthorizedOfficialFirstName: | ZIAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6178335626 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.