Provider Demographics
NPI:1780600825
Name:THE SPAULDING REHABILITATION HOSPITAL CORPORATION
Entity type:Organization
Organization Name:THE SPAULDING REHABILITATION HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-952-5000
Mailing Address - Street 1:300 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-3109
Mailing Address - Country:US
Mailing Address - Phone:857-282-0421
Mailing Address - Fax:617-952-5943
Practice Address - Street 1:300 1ST AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-3109
Practice Address - Country:US
Practice Address - Phone:617-952-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2321283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1100203Medicaid
MA702339OtherHPHC-AMBULANCE SVCS
MA1202278Medicaid
MA806723OtherAMBULANCE SVCS-SEC HRZNS
MA900423OtherHPHC-INP&OUTPT
MA903111OtherTUFTS OUTPATIENT
MAMAS2222203510OtherBCBS-MA OUTPATIENT
MAMAS2222203501OtherBCBS-MA INPATIENT
MA00030497OtherNHP-AMBULANCE SVCS
MA101859OtherBCBS-MA AMBULANCE SVCS
MA1720732Medicaid
MA97277101OtherNETWORK HEALTH-AMBULANCE
MA000000025461OtherBOSTON HEALTH NET-AMBULAN
MA800151OtherTUFTS INPATIENT
MA800151OtherTUFTS INPATIENT
MA806723OtherAMBULANCE SVCS-SEC HRZNS