Provider Demographics
NPI:1447214622
Name:NANTUCKET COTTAGE HOSPITAL
Entity Type:Organization
Organization Name:NANTUCKET COTTAGE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-825-8205
Mailing Address - Street 1:57 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-2799
Mailing Address - Country:US
Mailing Address - Phone:508-825-8100
Mailing Address - Fax:508-825-8101
Practice Address - Street 1:57 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-2799
Practice Address - Country:US
Practice Address - Phone:508-825-8100
Practice Address - Fax:508-825-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA099282NC0060X
MA2044282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1000527Medicaid
MA900171OtherHOSPITAL HARVARD PILGRAM
MA2222008101OtherHOSPITAL BXBS INPATIENT
MA2222008110OtherHOSPITAL BXBS OUTPATIENT
MA1201301Medicaid
MA1201310Medicaid
MA1001591Medicaid
MA70010000120199OtherCHHD - BXBS
MA2222008110OtherHOSPITAL BXBS OUTPATIENT
MA220177Medicare Oscar/Certification