Healthcare Provider Details

I. General information

NPI: 1649418575
Provider Name (Legal Business Name): ECHN JOHNSON MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 01/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CHESTNUT HILL RD
STAFFORD SPRINGS CT
06076-4005
US

IV. Provider business mailing address

320 MAIN ST
MANCHESTER CT
06040-4144
US

V. Phone/Fax

Practice location:
  • Phone: 860-684-8290
  • Fax: 860-684-8179
Mailing address:
  • Phone: 860-646-1222
  • Fax: 860-647-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KEVIN MURPHY
Title or Position: CEO
Credential:
Phone: 860-533-2925