1447275037 NPI number — SOUTHCOAST HOSPITALS GROUP, INC

Table of content: (NPI 1447275037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447275037 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:
Provider Other Organization Name Type Code:
6
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:
1447275037
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:
101 PAGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-3464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-997-1515
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2006

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: 000000020853 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0460908 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 982007 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1201751 . This is a "MA BEHAVIORAL HEALTH PART" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0100151 , 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: 1001949 . This is a "MA BEHAVIORAL HEALTH PART" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200772 . This is a "BLUE CHIP RI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110022082D , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2222002101 . This is a "BLUE CROSS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 982006 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: S012200 . This is a "TRICARE FOR LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000005125 . This is a "BLUE CROSS RI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110022082H , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2222002110 . This is a "BLUE CROSS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2222002130 . This is a "BLUE CROSS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 900014 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: OP00151 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 113809100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".