Healthcare Provider Details

I. General information

NPI: 1497832646
Provider Name (Legal Business Name): MARTHA'S VINEYARD HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL RD
OAK BLUFFS MA
02557
US

IV. Provider business mailing address

PO BOX 1477 1 HOSPITAL RD
OAK BLUFFS MA
02557
US

V. Phone/Fax

Practice location:
  • Phone: 508-693-0410
  • Fax: 508-696-8516
Mailing address:
  • Phone: 508-693-0410
  • Fax: 508-696-8516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number2042
License Number StateMA

VIII. Authorized Official

Name: MR. BRENDAN O'REILLY
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 617-726-3221