| Johnson Memorial Hospital, Inc. | |
|
201 Chestnut Hill Road Stafford Springs CT 06076-0860 | |
| (860) 684-4251 | |
| Not Available |
| Full Name | Johnson Memorial Hospital, Inc. |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 201 Chestnut Hill Road, Stafford Springs, Connecticut |
| Authorized Official Name and Position | Stuart E. Rosenberg (PRESIDENT) |
| Authorized Official Contact | 8606848235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnson Memorial Hospital, Inc. 201 Chestnut Hill Rd Stafford Springs CT 06076-4005 Ph: (860) 684-4251 | Johnson Memorial Hospital, Inc. 201 Chestnut Hill Road Stafford Springs CT 06076-0860 Ph: (860) 684-4251 |
| NPI Number | 1932123569 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 10/26/2016 |
| Medicare PECOS PAC ID | 4486959137 |
|---|---|
| Medicare Enrollment ID | O20160218000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932123569 | NPI | - | NPPES |
| 4024980 | Medicaid | CT | |
| 4041687 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0072 (Connecticut) | Secondary |
| 282N00000X | General Acute Care Hospital | 0072 (Connecticut) | Primary |
Robert D. Carlson, M.d. , Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 47 E Main St, Stafford Springs, CT 06076 Phone: 860-684-5871 Fax: 860-684-0469 |