Provider Demographics
NPI:1376716670
Name:LAWRENCE & MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:LAWRENCE & MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-442-0711
Mailing Address - Street 1:52 HAZELNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3268
Mailing Address - Country:US
Mailing Address - Phone:860-446-8265
Mailing Address - Fax:860-448-6961
Practice Address - Street 1:52 HAZELNUT HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3268
Practice Address - Country:US
Practice Address - Phone:860-446-8265
Practice Address - Fax:860-448-6961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty