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General NPI Number Information
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NPI Number | 1316917941
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Entity Type | Organization
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Legal Business Name | NORTHEAST HOSPITAL CORPORATION
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 85 HERRICK ST BEVERLY HOSPITAL
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City | BEVERLY
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State | MA
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Zip | 01915-1776
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Country | US
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Telephone | 978-922-3000
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Fax | 978-921-7071
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Provider Business Mailing Address
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Address Line | 85 HERRICK ST BEVERLY HOSPITAL
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City | BEVERLY
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State | MA
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Zip | 01915-1776
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Country | US
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Telephone | 978-922-3000
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Fax | 978-921-7071
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Authorized Official
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Title or Position | CEO
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Name | MR. PHILIP CORMIER
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Credential |
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Telephone | 978-922-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | V93D
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 15
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License Number State | MA
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