Provider Demographics
NPI:1790740777
Name:WINCHESTER HOSPITAL
Entity Type:Organization
Organization Name:WINCHESTER HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.FINANCE/ADMINISTRATION SVCS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-756-2129
Mailing Address - Street 1:41 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1446
Mailing Address - Country:US
Mailing Address - Phone:781-756-2415
Mailing Address - Fax:781-756-2996
Practice Address - Street 1:41 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1446
Practice Address - Country:US
Practice Address - Phone:781-756-2415
Practice Address - Fax:781-756-2996
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINCHESTER HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-20
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2094282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA50-00006OtherUNITED HEALTH INPATIENT
MA60848OtherUS HEALTHCARE INPT/OUTPT
MA901923OtherTUFTS INPATIENT
MA900046OtherTUFTS OUTPATIENT
MA1099787Medicaid
MA1202049Medicaid
MA900524OtherHARVARD PILGRIM OUTPT/INP
MA55-00047OtherUNITED HEALTH OUTPATIENT
MA1099787Medicaid
MA0005018Medicare PIN