Healthcare Provider Details

I. General information

NPI: 1659241560
Provider Name (Legal Business Name): ATHOL MEMORIAL HOSPITAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 MAIN ST
ATHOL MA
01331-3535
US

IV. Provider business mailing address

242 GREEN ST
GARDNER MA
01440-1336
US

V. Phone/Fax

Practice location:
  • Phone: 978-249-3511
  • Fax: 978-249-2651
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: JOHN BUJAK
Title or Position: CFO
Credential:
Phone: 508-450-6027