Provider Demographics
NPI:1235322777
Name:ST ANNES HOSPITAL
Entity Type:Organization
Organization Name:ST ANNES HOSPITAL
Other - Org Name:ST. ANNE'S CENTER FOR ORTHOPEDIC AND SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-624-9030
Mailing Address - Street 1:191 BEDFORD ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3011
Mailing Address - Country:US
Mailing Address - Phone:508-235-5782
Mailing Address - Fax:508-235-5786
Practice Address - Street 1:191 BEDFORD ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3011
Practice Address - Country:US
Practice Address - Phone:508-235-5782
Practice Address - Fax:508-235-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3031173Medicaid
MAJ14960Medicare PIN
MA3031173Medicaid
MA000326901Medicare PIN
MAJ1496001Medicare PIN
MAA3794801Medicare PIN
MA220020Medicare PIN
MAK08332002Medicare PIN