Provider Demographics
NPI:1851418222
Name:HARRINGTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HARRINGTON MEMORIAL HOSPITAL
Other - Org Name:G.B. WELLS HUMAN SERVICES CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VO OF BEHAVIORAL HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BRECHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:508-765-2233
Mailing Address - Street 1:29 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-1823
Mailing Address - Country:US
Mailing Address - Phone:508-765-2233
Mailing Address - Fax:508-764-2462
Practice Address - Street 1:29 PINE ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-1823
Practice Address - Country:US
Practice Address - Phone:508-765-2233
Practice Address - Fax:508-764-2462
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRINGTON MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231265282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1200704Medicaid
MA1200704Medicaid