Healthcare Provider Details

I. General information

NPI: 1750301636
Provider Name (Legal Business Name): SOUTHCOAST HOSPITALS GROUP,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

IV. Provider business mailing address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-3131
  • Fax:
Mailing address:
  • Phone: 508-679-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberV113
License Number StateMA

VIII. Authorized Official

Name: WILLIAM E GRIGG
Title or Position: EXECCUTIVE VICE PRESIDENT & CFO
Credential: CPA, FHFMA
Phone: 508-961-5016