Provider Demographics
NPI:1346575552
Name:MT AUBURN HOSPITAL
Entity type:Organization
Organization Name:MT AUBURN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-245-6238
Mailing Address - Street 1:104 ADAMS ST
Mailing Address - Street 2:APT 10
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3947
Mailing Address - Country:US
Mailing Address - Phone:914-874-6138
Mailing Address - Fax:
Practice Address - Street 1:104 ADAMS ST
Practice Address - Street 2:APT 10
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3947
Practice Address - Country:US
Practice Address - Phone:914-874-6138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241550282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital