# SOUTHCOAST HOSPITALS GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHCOAST HOSPITALS GROUP, INC
- **Other names:** Southcoast Specialty Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568876589
- **Legal business name:** SOUTHCOAST HOSPITALS GROUP, INC
- **Authorized official:** WADE DUDLEY BROUGHMAN (EVP-CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (508) 973-2908

## Contact information

- **Practice address:** 206 MILL RD, FAIRHAVEN, MA 02719-5208
- **Practice address phone:** (508) 973-3320
- **Practice address fax:** (508) 973-3325
- **Mailing address:** 206 MILL RD, FAIRHAVEN, MA 02719-5208
- **Mailing address phone:** (508) 973-3320
- **Mailing address fax:** (508) 973-3325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | V113 | MA | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | V113 | MA | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/18/2014
- **Last updated:** 08/17/2023