Organization
SOUTHCOAST HOSPITALS GROUP, INC
Active
Parent organization
SOUTHCOAST HOSPITALS GROUP, INC
Other names
Southcoast Specialty Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCOAST HOSPITALS GROUP, INC
Authorized official
WADE DUDLEY BROUGHMAN (EVP-CHIEF FINANCIAL OFFICER)
(508) 973-2908
Entity
Organization
Contact information
Practice address
206 MILL RD, FAIRHAVEN, MA 02719-5208
(508) 973-3320
(508) 973-3325
Mailing address
206 MILL RD, FAIRHAVEN, MA 02719-5208
(508) 973-3320
(508) 973-3325
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
V113
MA
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
V113
MA
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
06/18/2014
Last updated
08/17/2023
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