Provider Demographics
NPI:1003873233
Name:MIDDLESEX HOSPITAL
Entity Type:Organization
Organization Name:MIDDLESEX HOSPITAL
Other - Org Name:MIDDLESEX HOSPITAL HOMECARE AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-358-5730
Mailing Address - Street 1:770 SAYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4739
Mailing Address - Country:US
Mailing Address - Phone:860-358-5730
Mailing Address - Fax:860-358-5723
Practice Address - Street 1:117 MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3849
Practice Address - Country:US
Practice Address - Phone:860-358-5600
Practice Address - Fax:860-358-5723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDDLESEX HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-01
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT07-1522AMedicare ID - Type UnspecifiedMEDICARE PROV #