Provider Demographics
NPI:1689749079
Name:HEBREW HOME AND HOSPITAL, INC
Entity type:Organization
Organization Name:HEBREW HOME AND HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT, CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOULE
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:860-523-3800
Mailing Address - Street 1:1 ABRAHMS BLVD
Mailing Address - Street 2:PHARMACY
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1525
Mailing Address - Country:US
Mailing Address - Phone:860-523-3974
Mailing Address - Fax:860-523-3926
Practice Address - Street 1:1 ABRAHMS BLVD
Practice Address - Street 2:PHARMACY
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1525
Practice Address - Country:US
Practice Address - Phone:860-523-3974
Practice Address - Fax:860-523-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
281P00000X
CT333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered281P00000XHospitalsChronic Disease Hospital
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0720284OtherNCPDP#