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General NPI Number Information
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NPI Number | 1568876589
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Entity Type | Organization
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Legal Business Name | SOUTHCOAST HOSPITALS GROUP, INC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 206 MILL RD
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5208
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Country | US
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Telephone | 508-973-3320
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Fax | 508-973-3325
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Provider Business Mailing Address
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Address Line | 206 MILL RD
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5208
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Country | US
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Telephone | 508-973-3320
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Fax | 508-973-3325
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Authorized Official
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Title or Position | EVP-CHIEF FINANCIAL OFFICER
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Name | WADE DUDLEY BROUGHMAN
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Credential |
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Telephone | 508-973-2908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | V113
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | V113
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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