Provider Demographics
NPI:1669558474
Name:SOUTH SHORE HOSPITAL INC.
Entity type:Organization
Organization Name:SOUTH SHORE HOSPITAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PASCARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-624-7891
Mailing Address - Street 1:30 RESERVOIR PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-1055
Mailing Address - Country:US
Mailing Address - Phone:781-617-7891
Mailing Address - Fax:781-792-4201
Practice Address - Street 1:100 BAY STATE DRIVE
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-9060
Practice Address - Country:US
Practice Address - Phone:781-849-1710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH SHORE HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-27
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000021549OtherBOSTON MEDICAL CTR HLTH N
0605875OtherCOMMISSION OF THE BLIND
MA0605875Medicaid
702005OtherHARVARD PILGRIM HLTH CARE
803015OtherTUFTS HEALTH PLAN
120082OtherBLUE CROSS BLUE SHIELD
0009286OtherNEIGHBORHOOD HEALTH
1339OtherCIGNA
MA0605875Medicaid