Provider Demographics
NPI:1730363276
Name:BLK INC.
Entity type:Organization
Organization Name:BLK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:L
Authorized Official - Last Name:KITTREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:617-773-7426
Mailing Address - Street 1:470 SOUTHERN ARTERY
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4614
Mailing Address - Country:US
Mailing Address - Phone:617-773-7426
Mailing Address - Fax:617-770-9453
Practice Address - Street 1:470 SOUTHERN ARTERY
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4614
Practice Address - Country:US
Practice Address - Phone:617-773-7426
Practice Address - Fax:617-770-9453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2083332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMA2083OtherEYEMED
MA1529072OtherMASSHEALTH
MA412958OtherBLUE CROSS BLUE SHIELD
MA0940720001Medicare NSC