1225165699 NPI number — SAINT ANNE'S HOSPITAL

Table of content: (NPI 1225165699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225165699 NPI number — SAINT ANNE'S HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT ANNE'S HOSPITAL
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:
HOPE HOUSE OF SAINT ANNE'S HOSPITAL
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:
1225165699
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
795 MIDDLE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02721-1733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-674-5741
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
306 OSBORN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02724-3411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-235-5355
Provider Business Practice Location Address Fax Number:
508-324-9801
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RAMOS
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
F
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
508-235-5355

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  1903799 , 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: 1903799 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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