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General NPI Number Information
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NPI Number | 1366433104
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Entity Type | Organization
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Legal Business Name | BOSTON MEDICAL CENTER CORPORATION
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 732 HARRISON AVE
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City | BOSTON
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State | MA
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Zip | 02118-2309
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Country | US
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Telephone | 617-638-8130
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Fax | 617-638-8125
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Provider Business Mailing Address
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Address Line | 732 HARRISON AVE
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City | BOSTON
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State | MA
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Zip | 02118-2309
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Country | US
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Telephone | 617-638-8130
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Fax | 617-638-8125
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Authorized Official
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Title or Position | VP & CHIEF PHARMACY OFFICER
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Name | MR. BHAVESH SHAH
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Credential |
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Telephone | 617-638-6789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 340
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License Number State | MA
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