Provider Demographics
NPI:1396738159
Name:MARLBOROUGH HOSPITAL CORP
Entity type:Organization
Organization Name:MARLBOROUGH HOSPITAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-486-5804
Mailing Address - Street 1:157 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1228
Mailing Address - Country:US
Mailing Address - Phone:508-481-5000
Mailing Address - Fax:508-486-5606
Practice Address - Street 1:157 UNION ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1228
Practice Address - Country:US
Practice Address - Phone:508-481-5000
Practice Address - Fax:508-486-5606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QC1500X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000049OtherFALLON
MA001387OtherMBHP
MA20548OtherHEALTHNET
MA900020OtherTUFTS INPT
MANP00266-70OtherBOSTON HEALTH NET
MA1000454Medicaid
MA1201107Medicaid
MA000000020548OtherBMC HEALTHNET PLAN
CT003066760OtherCT MEDICAID
MA1002040OtherBEACON
MA0061895OtherUNITED HEALTH CARE
MA900116OtherHARVARD PILGRIM
MA2222004910OtherBLUE CROSS
MA42695OtherMAGELLAN
MA44543345OtherCHAMPUS
MA0007126OtherNHP
MA796300OtherNETWORK HEALTH
MA900744OtherTUFTS OUTPT
MA42695OtherMAGELLAN