Provider Demographics
NPI:1891228490
Name:GENERAL HOSPITAL CORP
Entity Type:Organization
Organization Name:GENERAL HOSPITAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPH
Authorized Official - Phone:617-724-9154
Mailing Address - Street 1:300 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-3675
Mailing Address - Country:US
Mailing Address - Phone:781-485-6015
Mailing Address - Fax:
Practice Address - Street 1:300 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3675
Practice Address - Country:US
Practice Address - Phone:781-485-6015
Practice Address - Fax:781-485-6098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REVERE HEALTHCARE CENTER PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital