Provider Demographics
NPI:1568771616
Name:NORTH SHORE MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTH SHORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF, PALLIATIVE CARE
Authorized Official - Prefix:DR
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-354-3090
Mailing Address - Street 1:81 HIGHLAND AVE
Mailing Address - Street 2:PALLIATIVE CARE DEPT
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2714
Mailing Address - Country:US
Mailing Address - Phone:978-354-3090
Mailing Address - Fax:978-740-0418
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:PALLIATIVE CARE DEPT
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-354-3090
Practice Address - Fax:978-740-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN235771282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital