Provider Demographics
NPI:1801994389
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:EXECUTIVE VICE PRESIDENT COO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-340-8622
Mailing Address - Street 1:100 BAY STATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-9060
Mailing Address - Country:US
Mailing Address - Phone:781-849-1710
Mailing Address - Fax:
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:2006-09-20
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA009251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
702240OtherHARVARD PILGRIM HEALTH CA
803016OtherTUFTS HEALTH PLAN
MA0605883Medicaid
221517OtherBLUE CROSS BLUE SHIELD
803016OtherTUFTS HEALTH PLAN