1780600825 NPI number — THE SPAULDING REHABILITATION HOSPITAL CORPORATION

Table of content: (NPI 1780600825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780600825 NPI number — THE SPAULDING REHABILITATION HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE SPAULDING REHABILITATION HOSPITAL CORPORATION
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:
1780600825
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 1ST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLESTOWN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02129-3109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-282-0421
Provider Business Mailing Address Fax Number:
617-952-5943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 1ST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTOWN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02129-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-952-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DESANTIS
Authorized Official First Name:
SAMANTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR FINANCE
Authorized Official Telephone Number:
617-952-5000

Provider Taxonomy Codes

  • Taxonomy code: 283X00000X , with the licence number:  2321 , 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: 1100203 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 702339 . This is a "HPHC-AMBULANCE SVCS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1202278 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806723 . This is a "AMBULANCE SVCS-SEC HRZNS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900423 . This is a "HPHC-INP&OUTPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 903111 . This is a "TUFTS OUTPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MAS2222203510 . This is a "BCBS-MA OUTPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MAS2222203501 . This is a "BCBS-MA INPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 00030497 . This is a "NHP-AMBULANCE SVCS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 101859 . This is a "BCBS-MA AMBULANCE SVCS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1720732 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97277101 . This is a "NETWORK HEALTH-AMBULANCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000025461 . This is a "BOSTON HEALTH NET-AMBULAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 800151 . This is a "TUFTS INPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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