1285171934 NPI number — UMASS MEMORIAL HEALTHALLIANCE CLINTON HOSPITAL INC

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 1285171934 NPI number — UMASS MEMORIAL HEALTHALLIANCE CLINTON HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UMASS MEMORIAL HEALTHALLIANCE CLINTON 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:
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:
1285171934
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 HOSPITAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEOMINSTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01453-2205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-466-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 HIGHLAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01510-1037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-368-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/19/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BRONHARD
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
E
Authorized Official Title or Position:
TREASURER AND CFO
Authorized Official Telephone Number:
978-870-1550

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X , 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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