1396738159 NPI number — MARLBOROUGH HOSPITAL CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396738159 NPI number — MARLBOROUGH HOSPITAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARLBOROUGH HOSPITAL CORP
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:
1396738159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
157 UNION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARLBOROUGH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01752-1228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-481-5000
Provider Business Mailing Address Fax Number:
508-486-5606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
157 UNION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARLBOROUGH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01752-1228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-481-5000
Provider Business Practice Location Address Fax Number:
508-486-5606
Provider Enumeration Date:
08/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MCCUE
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
508-486-5804

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000049 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 001387 . This is a "MBHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 20548 . This is a "HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900020 . This is a "TUFTS INPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: NP00266-70 . This is a "BOSTON HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000454 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1201107 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000020548 . This is a "BMC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 003066760 . This is a "CT MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1002040 . This is a "BEACON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0061895 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900116 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222004910 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 42695 . This is a "MAGELLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 44543345 . This is a "CHAMPUS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007126 . This is a "NHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 796300 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900744 . This is a "TUFTS OUTPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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