# MIDSTATE MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427007848
- **Authorized official:** GERALD BOISVERT (VP CFO)
- **Authorized official phone:** (860) 545-0585

## Contact information

- **Practice address:** 435 LEWIS AVENUE, MERIDEN, CT 06451-2101
- **Practice address phone:** (203) 694-8200
- **Practice address fax:** (860) 696-6035
- **Mailing address:** P.O. BOX 4131, YALESVILLE, CT 06492-1481
- **Mailing address phone:** (203) 284-1340
- **Mailing address fax:** (203) 265-4557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QE0002X | Emergency Care Clinic/Center | — | NULL | — |
| 282N00000X | General Acute Care Hospital | 0070 | CT | — |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |
| 363LN0000X | Neonatal Nurse Practitioner | — | NULL | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 11/27/2023