Basic Information
| Provider Information | |||||||||
| NPI: | 1477596310 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COOLEY DICKINSON HOSPITAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 LOCUST STREET | ||||||||
| Address2: | P.O. BOX 5001 | ||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010615001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135822000 | ||||||||
| FaxNumber: | 4135822680 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 LOCUST ST | ||||||||
| Address2: | |||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010602052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135822000 | ||||||||
| FaxNumber: | 4135822680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 04/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | MARQUSEE | ||||||||
| AuthorizedOfficialFirstName: | JOANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT & CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4135822000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2155 | MA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 000000006547 | 01 | MA | BMC HEALTHNET | OTHER | 10022691 | 01 | MA | CAPITAL DISTRICT HEALTH P | OTHER | 1212613 | 05 | MA | MEDICAID | 900390 | 01 | MA | TUFTS OUTPATIENT | OTHER | H3596977 | 01 | MA | OXFORD HEALTH PLAN | OTHER | 114506800 | 01 | MA | US DEPT OF LABOR OWCP | OTHER | C002222001510 | 01 | MA | MEDEX | OTHER | 0007478 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 2222001501 | 01 | MA | BLUE CROSS INPATIENT | OTHER | 64246 | 01 | MA | AETNA | OTHER | 997175 | 01 | MA | CONNECTICARE | OTHER | 1010476 | 05 | MA | MEDICAID | 11535 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 900170 | 01 | MA | HARVARD PILGRIM HEALTH PL | OTHER | D019692 | 01 | MA | CHAMPVA | OTHER | 904857 | 01 | MA | TUFTS INPATIENT | OTHER | 2222001510 | 01 | MA | BLUE CROSS OUTPATIENT | OTHER |