1629346127 NPI number — DAY KIMBALL HOSPITAL OF WINDHAM COUNTY

Table of content: (NPI 1629346127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629346127 NPI number — DAY KIMBALL HOSPITAL OF WINDHAM COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAY KIMBALL HOSPITAL OF WINDHAM COUNTY
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:
DAY KIMBALL HOSPITIAL PHYSICIAN PRACTICES
Provider Other Organization Name Type Code:
3
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:
1629346127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 POMFRET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PUTNAM
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06260-1836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-928-6541
Provider Business Mailing Address Fax Number:
860-963-6450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 POMFRET ST
Provider Second Line Business Practice Location Address:
SUITE CSB2
Provider Business Practice Location Address City Name:
PUTNAM
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06260-1836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-928-6541
Provider Business Practice Location Address Fax Number:
860-963-6450
Provider Enumeration Date:
12/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DROUIN
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
860-928-6541

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com