Provider Demographics
NPI:1598795122
Name:SAINT MARY'S HOSPITAL INC.
Entity Type:Organization
Organization Name:SAINT MARY'S HOSPITAL INC.
Other - Org Name:INPATIENT PSYCH EXEMPT UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:REGIONAL DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-714-4396
Mailing Address - Street 1:56 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1221
Mailing Address - Country:US
Mailing Address - Phone:203-709-6000
Mailing Address - Fax:
Practice Address - Street 1:56 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1221
Practice Address - Country:US
Practice Address - Phone:203-709-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY HEALTH OF NEW ENGLAND CORPORATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-03
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0055273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT19BOtherANTHEM BC BS IP PSYCH
CTIR0800OtherHEALTHNET PROV NO.
CT004041760Medicaid
CTH01112OtherOXFORD PROV ID NO.