1407804669 NPI number — THE LOWELL GENERAL HOSPITAL

Table of content: (NPI 1407804669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407804669 NPI number — THE LOWELL GENERAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE LOWELL GENERAL 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:
LOWELL GENERAL 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:
1407804669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1819
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01853-1819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-937-6000
Provider Business Mailing Address Fax Number:
978-788-7822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 VARNUM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01854-2134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-937-6000
Provider Business Practice Location Address Fax Number:
978-788-7822
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GREEN
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
978-788-7143

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  2040 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336I0012X , with the licence number: MA0114847 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 110026472C , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2242321 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110026472B , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112231500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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