1134227606 NPI number — SOUTH SHORE HOSPITAL INC.

Table of content: (NPI 1134227606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134227606 NPI number — SOUTH SHORE HOSPITAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH SHORE HOSPITAL 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:
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:
1134227606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
55 FOGG ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH WEYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02190
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-340-8000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 FOGG ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH WEYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-340-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COCO
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP/CFO
Authorized Official Telephone Number:
781-340-8000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  2107 , 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: 2222010010 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 900115 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000020047 . This is a "BOSTON MEDICAL CENTER HEA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2222010001 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 902226 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2222010030 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90015 . This is a "HARVARD PILGRIM HEALTH CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1201662 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50097059 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1001426 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 115370100 . 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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