Provider Demographics
NPI:1740713288
Name:GENERAL HOSPITAL CORP
Entity type:Organization
Organization Name:GENERAL HOSPITAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT PHARMACY
Authorized Official - Prefix:MRS
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 1:40 2ND AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1132
Mailing Address - Country:US
Mailing Address - Phone:781-487-4390
Mailing Address - Fax:781-487-4391
Practice Address - Street 1:40 2ND AVE FL 4
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1132
Practice Address - Country:US
Practice Address - Phone:781-487-4390
Practice Address - Fax:781-487-4391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENERAL HOSPITAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center