=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124184494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BERKSHIRE MEDICAL CENTER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2006
-----------------------------------------------------
Last Update Date | 03/19/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 725 NORTH ST
-----------------------------------------------------
City | PITTSFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01201-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-447-2000
-----------------------------------------------------
Fax | 413-447-2803
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 725 NORTH ST PO BOX 4999
-----------------------------------------------------
City | PITTSFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01201-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-447-2000
-----------------------------------------------------
Fax | 413-447-2803
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | MRS. DARLENE RODOWICZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 413-447-2000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 273Y00000X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Hospital Unit
-----------------------------------------------------
License Number | VQKK
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------