1306871223 NPI number — SOUTHCOAST HOSPITALS GROUP, INC

Table of content: (NPI 1306871223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306871223 NPI number — SOUTHCOAST HOSPITALS GROUP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHCOAST HOSPITALS GROUP, 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:
CHARLTON MEMORIAL 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:
1306871223
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
363 HIGHLAND AVE
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:
02720-3703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-679-3131
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
363 HIGHLAND AVE
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:
02720-3703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-679-3131
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRIGG
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT & CFO
Authorized Official Telephone Number:
508-961-5016

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  V113 , 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: 000000020852 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000005124 . This is a "BLUE CROSS RI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2222005510 . This is a "BLUE CROSS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 982009 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222200501 . This is a "BLUE CROSS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5124-4 . This is a "BLUE CROSS RI PLAN 65" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110022082D , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: OP20055 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220074 . This is a "MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900006 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 982008 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: H00117 . This is a "BLUE CHIP RI" identifier . This identifiers is of the category "OTHER".
  • Identifier: S007424 . This is a "TICARE FOR LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0220055 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1201751 . This is a "MA BEHAVIORAL HEALTH PART" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2222005530 . This is a "BLUE CROSS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110022082H , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2259416 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110660500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com