Provider Demographics
NPI:1568532810
Name:THE HOSPITAL OF CENTRAL CONNECTICUT
Entity Type:Organization
Organization Name:THE HOSPITAL OF CENTRAL CONNECTICUT
Other - Org Name:NEW BRITAIN GENERAL HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEDVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-224-5675
Mailing Address - Street 1:100 GRAND ST
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5675
Mailing Address - Fax:860-224-5774
Practice Address - Street 1:100 GRAND ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5675
Practice Address - Fax:860-224-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001821282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001821OtherLICENSE