Provider Demographics
NPI:1477596310
Name:COOLEY DICKINSON HOSPITAL INC
Entity Type:Organization
Organization Name:COOLEY DICKINSON HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUSEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-582-2000
Mailing Address - Street 1:30 LOCUST STREET
Mailing Address - Street 2:P.O. BOX 5001
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-5001
Mailing Address - Country:US
Mailing Address - Phone:413-582-2000
Mailing Address - Fax:413-582-2680
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2000
Practice Address - Fax:413-582-2680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2155282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000006547OtherBMC HEALTHNET
MA10022691OtherCAPITAL DISTRICT HEALTH P
MA1212613Medicaid
MA900390OtherTUFTS OUTPATIENT
MAH3596977OtherOXFORD HEALTH PLAN
MA114506800OtherUS DEPT OF LABOR OWCP
MAC002222001510OtherMEDEX
MA0007478OtherNEIGHBORHOOD HEALTH PLAN
MA2222001501OtherBLUE CROSS INPATIENT
MA64246OtherAETNA
MA997175OtherCONNECTICARE
MA1010476Medicaid
MA11535OtherHEALTH NEW ENGLAND
MA900170OtherHARVARD PILGRIM HEALTH PL
MAD019692OtherCHAMPVA
MA904857OtherTUFTS INPATIENT
MA2222001510OtherBLUE CROSS OUTPATIENT
MA11535OtherHEALTH NEW ENGLAND
MA997175OtherCONNECTICARE