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1184639973

NPI Code Detail

MEDICARE: THE GRIFFIN HOSPITAL

MEDICARE: THE GRIFFIN HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0002X	Emergency Care Clinic/Center	0034	CT
2	208D00000X	General Practice Physician	0034	CT
3	2084P0800X	Psychiatry Physician	0034	CT
4	282N00000X	General Acute Care Hospital	0034	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0464667	OTHER	CT	CIGNA
3	60054	OTHER	CT	AETNA
4	87726	OTHER	CT	UNITED HEALTHCARE
5	H03255	OTHER	CT	OXFORD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	990352	OTHER	CT	CONNECTICARE
8	028	OTHER	CT	BLUE CROSS MEDICAL
9	28B	OTHER	CT	ANTHEM BLUE CROSS PSYCH
10	000991	OTHER	CT	HEALTHNET
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184639973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GRIFFIN HOSPITAL

Provider Business Mailing Address
First Line	:	130 DIVISION ST
Second Line	:
City	:	DERBY
State	:	CT
Zip	:	06418-1326
Country	:	US
Telephone Number	:	203-732-7360
Fax Number	:	203-732-7386

Provider Business Practice Location Address
First Line	:	130 DIVISION ST
Second Line	:
City	:	DERBY
State	:	CT
Zip	:	06418-1326
Country	:	US
Telephone Number	:	203-732-7360
Fax Number	:	203-732-7386

Authorized Official
Title or Position	:	PRESIDENT - CEO
Name	:	MR. PATRICK CHARMEL
Credential	:
Telephone Number	:	203-732-7500

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	06/03/2015

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Directions to “THE GRIFFIN HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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