1891718474 NPI number — SOUTHCOAST HOSPITALS GROUP, INC

Table of content: (NPI 1891718474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891718474 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:
TOBEY HOSPITAL - TRANSITIONAL CARE UNIT
Provider Other Organization Name Type Code:
5
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:
1891718474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2007
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:
43 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAREHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02571-2097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-295-0880
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2006

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: 314000000X , with the licence number:  3914 , 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: 686413 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".




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