Provider Demographics
NPI:1922024835
Name:SOUTHCOAST HOSPITALS GROUP, INC
Entity Type:Organization
Organization Name:SOUTHCOAST HOSPITALS GROUP, INC
Other - Org Name:TOBEY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIGG
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, FHFMA
Authorized Official - Phone:508-961-5016
Mailing Address - Street 1:363 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3703
Mailing Address - Country:US
Mailing Address - Phone:508-679-3131
Mailing Address - Fax:
Practice Address - Street 1:43 HIGH ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2097
Practice Address - Country:US
Practice Address - Phone:508-295-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHCOAST HEALTH SYSTEM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAV113282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
12923OtherAETNA
208299800OtherUS DEPT OF LABOR
2222007410OtherBLUE CROSS MA
RIOP20074Medicaid
MA110022082DMedicaid
2222007430OtherBLUE CROSS MA
900016OtherHARVARD PILGRIM
0000005119OtherBLUE CROSS RI
RI0220074Medicaid
0462672OtherCIGNA
904193OtherTUFTS
S012225OtherTRICARE FOR LIFE
MA110022082HMedicaid
000000020854OtherBMC HEALTHNET
1201751OtherMA BEHAVIORAL HEALTH PART
MA220074OtherMEDICARE
2222007401OtherBLUE CROSS MA
5000103OtherUNITED HEALTH PLANS
900032OtherTUFTS
2222007430OtherBLUE CROSS MA