Healthcare Provider Details

I. General information

NPI: 1982914909
Provider Name (Legal Business Name): FRANCISCAN HOSPITAL FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WARREN ST
BRIGHTON MA
02135-3602
US

IV. Provider business mailing address

30 WARREN ST
BRIGHTON MA
02135-3602
US

V. Phone/Fax

Practice location:
  • Phone: 617-779-1111
  • Fax: 617-779-1109
Mailing address:
  • Phone: 617-779-1111
  • Fax: 617-779-1109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number2221
License Number StateMA

VIII. Authorized Official

Name: DAVID MCLOON
Title or Position: GENERAL COUNSEL
Credential:
Phone: 617-779-1111