Healthcare Provider Details

I. General information

NPI: 1407804669
Provider Name (Legal Business Name): THE LOWELL GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 VARNUM AVE
LOWELL MA
01854-2134
US

IV. Provider business mailing address

PO BOX 1819
LOWELL MA
01853-1819
US

V. Phone/Fax

Practice location:
  • Phone: 978-937-6000
  • Fax: 978-788-7822
Mailing address:
  • Phone: 978-937-6000
  • Fax: 978-788-7822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2040
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberMA0114847
License Number StateMA

VIII. Authorized Official

Name: SUSAN GREEN
Title or Position: EVP CHIEF FINANCIAL OFFICER
Credential:
Phone: 978-788-7143