Healthcare Provider Details

I. General information

NPI: 1053776211
Provider Name (Legal Business Name): THE HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2015
Last Update Date: 12/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST # GB005 MA GENERAL HOSPTITAL
BOSTON MA
02114-2621
US

IV. Provider business mailing address

MA GENERAL HOSPTITAL 55 FRUIT STREET GB005
BOSTON MA
02114
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2515
  • Fax: 617-724-5013
Mailing address:
  • Phone: 617-726-2515
  • Fax: 617-724-5013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHERYL REILLY-TREMBALY
Title or Position: MANAGER
Credential:
Phone: 617-724-7875