Healthcare Provider Details

I. General information

NPI: 1366515280
Provider Name (Legal Business Name): MILTON HOSPITAL TCU UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 HIGHLAND ST
MILTON MA
02186-3800
US

IV. Provider business mailing address

92 HIGHLAND ST
MILTON MA
02186-3800
US

V. Phone/Fax

Practice location:
  • Phone: 617-696-4600
  • Fax: 617-313-1567
Mailing address:
  • Phone: 617-696-4600
  • Fax: 617-313-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: GAIL SCHROTH
Title or Position: DIRECTOR PATIENT FINANCIAL SERVICES
Credential:
Phone: 617-313-1214