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General NPI Number Information
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NPI Number | 1841802782
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Entity Type | Organization
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Legal Business Name | HENRY HEYWOOD MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 55 HOSPITAL DR
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City | WINCHENDON
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State | MA
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Zip | 01475-1899
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Country | US
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Telephone | 978-297-2311
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Fax |
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Provider Business Mailing Address
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Address Line | 242 GREEN ST
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City | GARDNER
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State | MA
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Zip | 01440-1336
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Country | US
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Telephone | 978-630-6944
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THOMAS J SULLIVAN
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Credential |
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Telephone | 978-630-6157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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