Provider Demographics
NPI:1447275037
Name:SOUTHCOAST HOSPITALS GROUP, INC
Entity type:Organization
Organization Name:SOUTHCOAST HOSPITALS GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIGG
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, FHFMA
Authorized Official - Phone:508-961-5016
Mailing Address - Street 1:363 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3703
Mailing Address - Country:US
Mailing Address - Phone:508-679-3131
Mailing Address - Fax:
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-997-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHCOAST HEALTH SYSTEM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-13
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAV113282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000020853OtherBMC HEALTHNET
0460908OtherCIGNA
982007OtherTUFTS
1201751OtherMA BEHAVIORAL HEALTH PART
RI0100151Medicaid
MA220074OtherMEDICARE
1001949OtherMA BEHAVIORAL HEALTH PART
200772OtherBLUE CHIP RI
MA110022082DMedicaid
2222002101OtherBLUE CROSS MA
982006OtherTUFTS
S012200OtherTRICARE FOR LIFE
0000005125OtherBLUE CROSS RI
MA110022082HMedicaid
2222002110OtherBLUE CROSS MA
2222002130OtherBLUE CROSS MA
900014OtherHARVARD PILGRIM
RIOP00151Medicaid
MA220074Medicare Oscar/Certification
MA220074OtherMEDICARE