Healthcare Provider Details

I. General information

NPI: 1861405979
Provider Name (Legal Business Name): ST. ANNE'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 MIDDLE ST
FALL RIVER MA
02721-1733
US

IV. Provider business mailing address

795 MIDDLE ST
FALL RIVER MA
02721-1733
US

V. Phone/Fax

Practice location:
  • Phone: 508-235-5318
  • Fax: 508-235-5091
Mailing address:
  • Phone: 508-235-5318
  • Fax: 508-235-5091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberOAUN
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0925268
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name: MR. SAZA LEE AHMAD
Title or Position: ADMINISTRATOR
Credential:
Phone: 508-235-5318