Provider Demographics
NPI:1902834880
Name:HARTFORD HOSPITAL
Entity Type:Organization
Organization Name:HARTFORD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BOISVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-545-0585
Mailing Address - Street 1:80 SEYMOUR ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-8000
Mailing Address - Country:US
Mailing Address - Phone:860-696-6010
Mailing Address - Fax:860-696-6190
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-696-6010
Practice Address - Fax:860-696-6190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
273Y00000X
CT0046282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0001352OtherUS HEALTHCARE
CT059672OtherVALUE OPTIONS
CT900006OtherCTCARE
CTH01316OtherOXFORD
CT004041869Medicaid
CT038157400OtherFEDERAL BLACK LUNG PROGRA
CT05BOtherANTHEM BLUE CROSS MH
CTIS10001OtherHEALTH NET
CT0006170150OtherAETNA
CT004064366Medicaid
CT004025151Medicaid
CT005OtherANTHEM BLUE CROSS
CT0319896OtherUNITED HEALTHCARE
CT4010864Medicaid
CTC001897OtherTRICARE
CT0006170150OtherAETNA
CT900006OtherCTCARE