1477596310 NPI number — COOLEY DICKINSON HOSPITAL INC

Table of content: (NPI 1477596310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477596310 NPI number — COOLEY DICKINSON HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COOLEY DICKINSON HOSPITAL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477596310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 LOCUST STREET
Provider Second Line Business Mailing Address:
P.O. BOX 5001
Provider Business Mailing Address City Name:
NORTHAMPTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01061-5001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-582-2000
Provider Business Mailing Address Fax Number:
413-582-2680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 LOCUST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-2052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-582-2000
Provider Business Practice Location Address Fax Number:
413-582-2680
Provider Enumeration Date:
06/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARQUSEE
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
413-582-2000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  2155 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000006547 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 10022691 . This is a "CAPITAL DISTRICT HEALTH P" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1212613 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 900390 . This is a "TUFTS OUTPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: H3596977 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 114506800 . This is a "US DEPT OF LABOR OWCP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: C002222001510 . This is a "MEDEX" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007478 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222001501 . This is a "BLUE CROSS INPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 64246 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 997175 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1010476 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11535 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900170 . This is a "HARVARD PILGRIM HEALTH PL" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: D019692 . This is a "CHAMPVA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 904857 . This is a "TUFTS INPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222001510 . This is a "BLUE CROSS OUTPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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