Healthcare Provider Details

I. General information

NPI: 1366433104
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

732 HARRISON AVE
BOSTON MA
02118-2309
US

IV. Provider business mailing address

732 HARRISON AVE
BOSTON MA
02118-2309
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-8130
  • Fax: 617-638-8125
Mailing address:
  • Phone: 617-638-8130
  • Fax: 617-638-8125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. BHAVESH SHAH
Title or Position: VP & CHIEF PHARMACY OFFICER
Credential:
Phone: 617-638-6789