Organization
ST. ELIZABETH'S HEALTHCARE AT HANSCOM AIR BASE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILES COVERDALE (CFO)
(617) 789-3000
Entity
Organization
Contact information
Practice address
1609 EGLIN ST, HANSCOM AFB, MA 01731-2613
(617) 789-2204
(617) 562-5415
Mailing address
1609 EGLIN ST, HANSCOM AFB, MA 01731-2613
(617) 789-2204
(617) 562-5415
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1214225
—
MA
Enumeration date
11/14/2006
Last updated
08/22/2020
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