| Northeast Hospital Corporation | |
|
85 Herrick Street Beverly MA 01915 | |
| (978) 922-3000 | |
| (978) 921-7048 |
| Full Name | Northeast Hospital Corporation |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 85 Herrick Street, Beverly, Massachusetts |
| Authorized Official Name and Position | Denis S Conroy (CEO) |
| Authorized Official Contact | 9789223000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Hospital Corporation 85 Herrick Street Medical Staff Office Beverly MA 01915 Ph: (978) 922-3000 | Northeast Hospital Corporation 85 Herrick Street Beverly MA 01915 Ph: (978) 922-3000 |
| NPI Number | 1407827710 |
|---|---|
| Provider Enumeration Date | 01/27/2006 |
| Last Update Date | 11/12/2014 |
| Medicare PECOS PAC ID | 1153213202 |
|---|---|
| Medicare Enrollment ID | O20180829002125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407827710 | NPI | - | NPPES |
| 1202626 | Medicaid | MA | |
| 2222003306 | Other | MD | BC INDEM IP PSYCH |
| 900082 | Other | MA | TUFTS MCR HMO OUTPAT |
| 901790 | Other | MA | TUFTS IP PSYCH |
| 1000039 | Medicaid | MA | |
| 2222003311 | Other | MA | BC HMO/PHO PSYCH OP |
| 2222003325 | Other | MA | BC OUTPAT INDEM PSYCH |
| 9343 | Other | MA | AETNA HMO PSYCH |
| BEV2222003311 | Other | MA | HMO BLUE PSYCH OP |
| 0007079 | Other | MA | NHP PSYCH |
| 1898639 | Medicaid | MA | |
| 2222003301 | Other | MA | BC HMO/PHO PSYCH IP |
| 900082 | Other | MA | TUFTS OUTPAT PSYCH |
| BEV2222003301 | Other | MD | HMO BLUE PSYCH IP |
| 901790 | Other | MA | TUFTS MCR HMO INPAT |
| S005394 | Other | MD | CHAMPUS |
| 903159 | Other | MA | HARVARD PILGRIM PSYCH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 15 (Massachusetts) | Primary |
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Secondary |
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