Basic Information
| Provider Information | |||||||||
| NPI: | 1699767491 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW ENGLAND BAPTIST HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 PARKER HILL AVE | ||||||||
| Address2: | |||||||||
| City: | ROXBURY CROSSING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021202847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177545800 | ||||||||
| FaxNumber: | 6177546418 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 PARKER HILL AVE | ||||||||
| Address2: | |||||||||
| City: | ROXBURY CROSSING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021202847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177545800 | ||||||||
| FaxNumber: | 6177546418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2005 | ||||||||
| LastUpdateDate: | 09/29/2009 | ||||||||
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| AuthorizedOfficialLastName: | HANNON | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 6177545001 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2059 | MA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1201336 | 05 | MA | MEDICAID | 1000543 | 05 | MA | MEDICAID | 900033 | 01 | MA | TUFTS OUTPATIENT | OTHER | NEW2222008810 | 01 | MA | BLUE CROSS OUTPATIENT | OTHER | NEW2222008830 | 01 | MA | BLUE CROSS DAY SURGERY | OTHER | NEW2222008801 | 01 | MA | BLUE CROSS INPATIENT | OTHER | 728263 | 01 | MD | TUFTS SNF | OTHER | 900073 | 01 | MA | HARVARD PILGRIM INPT/OUTP | OTHER | 903897 | 01 | MA | TUFTS INPATIENT | OTHER | NEW2222556301 | 01 | MA | BLUE CROSS SNF | OTHER |