Healthcare Provider Details

I. General information

NPI: 1265041305
Provider Name (Legal Business Name): THE LOWELL GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 VARNUM AVE
LOWELL MA
01854-2134
US

IV. Provider business mailing address

295 VARNUM AVE
LOWELL MA
01854-2134
US

V. Phone/Fax

Practice location:
  • Phone: 978-937-6000
  • Fax:
Mailing address:
  • Phone: 978-937-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM F WYMAN
Title or Position: SVP OF FINANCE
Credential:
Phone: 978-937-6000