Healthcare Provider Details

I. General information

NPI: 1619972445
Provider Name (Legal Business Name): QUINCY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WHITWELL ST
QUINCY MA
02169-1870
US

IV. Provider business mailing address

114 WHITWELL ST
QUINCY MA
02169-1870
US

V. Phone/Fax

Practice location:
  • Phone: 617-773-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number106
License Number StateMA

VIII. Authorized Official

Name: MR. MARK O'NEILL
Title or Position: CHEIF FINANCIAL OFFICER
Credential:
Phone: 617-376-5730