Provider Demographics
NPI:1750381281
Name:LAWRENCE GENERAL HOSPITAL
Entity type:Organization
Organization Name:LAWRENCE GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ABHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-683-4000
Mailing Address - Street 1:1 GENERAL ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2961
Mailing Address - Country:US
Mailing Address - Phone:978-683-4000
Mailing Address - Fax:978-946-8199
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-683-4000
Practice Address - Fax:978-946-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2099207P00000X, 207R00000X, 208000000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026771/BMedicaid
MA110026771/AMedicaid
MA220010Medicare PIN