Healthcare Provider Details

I. General information

NPI: 1497710115
Provider Name (Legal Business Name): BRADLEY MEMORIAL HOSPITAL AND HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MERIDEN AVENUE
SOUTHINGTON CT
06489
US

IV. Provider business mailing address

81 MERIDEN AVENUE
SOUTHINGTON CT
06489
US

V. Phone/Fax

Practice location:
  • Phone: 860-276-8326
  • Fax: 860-276-5081
Mailing address:
  • Phone: 860-276-8326
  • Fax: 860-276-5081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0026
License Number StateCT

VIII. Authorized Official

Name: MR. CLARENCE J SILVIA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 860-224-5900