Healthcare Provider Details
I. General information
NPI: 1114918950
Provider Name (Legal Business Name): BOSTON MEDICAL CENTER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2005
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
840 HARRISON AVE
BOSTON MA
02118-2905
US
IV. Provider business mailing address
840 HARRISON AVE
BOSTON MA
02118-2905
US
V. Phone/Fax
- Phone: 617-414-4883
- Fax: 617-414-5397
- Phone: 617-414-4883
- Fax: 617-414-5397
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANTHONY
HOLLENBERG
Title or Position: PRESIDENT
Credential:
Phone: 617-638-6903