Provider Demographics
NPI:1770696643
Name:HARTFORD HOSPITAL
Entity type:Organization
Organization Name:HARTFORD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-545-2746
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:2006-08-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046261QD0000X, 261QM0801X, 261QM0855X, 261QS0112X
CT0046261QE0002X, 261QE0700X, 3416A0800X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
No3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0319896OtherUNITED HEALTHCARE
CT038157400OtherFEDERAL BLACK LUNG
CT4064366Medicaid
CTOXFORDOtherH01316
CT0001352OtherUS HEALTHCARE
CT4025151Medicaid
CT05BOtherANTHEM BLUE CROSS
CTC001897OtherTRICARE
CT008020366Medicaid
CT0464730045OtherCIGNA
CT059672OtherVALUE OPTIONS
CT0006170150OtherAETNA
CT900777OtherTUFTS INSURANCE
CT005OtherANTHEM BLUE CROSS CT
CT4010864Medicaid
CTIS10001OtherHEALTHNET
CT05BOtherANTHEM BLUE CROSS
CT038157400OtherFEDERAL BLACK LUNG
CT059672OtherVALUE OPTIONS