1942367255 NPI number — WESTBOROUGH STATE HOSPITAL

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 1942367255 NPI number — WESTBOROUGH STATE HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTBOROUGH STATE 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:
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:
1942367255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WESTBOROUGH STATE HOSPITAL
Provider Second Line Business Mailing Address:
288 LYMAN STREET
Provider Business Mailing Address City Name:
WESTBOROUGH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WESTBOROUGH STATE HOSPITAL
Provider Second Line Business Practice Location Address:
288 LYMAN STREET
Provider Business Practice Location Address City Name:
WESTBOROUGH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-616-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
COTA
Authorized Official Telephone Number:
508-616-2100

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  2123 , 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)





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