Basic Information
| Provider Information | |||||||||
| NPI: | 1023240520 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SPAULDING HOSPITAL-CAMBRIDGE, INC. | ||||||||
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| OtherOrganizationName: | SPAULDING HOSPITAL FOR CONTINUING MEDICAL CARE - CAMBRIDGE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1575 CAMBRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021384308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178764344 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1575 CAMBRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021384308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178764344 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2009 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | REED | ||||||||
| AuthorizedOfficialFirstName: | CLAUDIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | INTERIM CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8572820722 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282E00000X | Y | Hospitals | Long Term Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 33 | 01 | BLUE CROSS | OTHER | 751815 | 01 | MA | TUFTS | OTHER | 110083948A | 05 | MA | MEDICAID | 910641 | 01 | MA | HARVARD PILGRIM | OTHER | 2233006902 | 01 | MA | BLUE CROSS | OTHER | 2233006901 | 01 | MA | BLUE CROSS | OTHER | 3071328 | 01 | NH | NEW HAMPSHIRE MEDICAID | OTHER |