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General NPI Number Information
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NPI Number | 1376460931
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Entity Type | Organization
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Legal Business Name | BOSTON MEDICAL CENTER - SOUTH CORPORATION
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/03/2026
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Provider Practice Location Address
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Address Line | 34 N PEARL ST
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City | BROCKTON
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State | MA
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Zip | 02301-1708
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Country | US
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Telephone | 508-408-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BOSTON MEDICAL CTR PL STE 1
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City | BOSTON
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State | MA
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Zip | 02118-2999
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARK JAY HEICHMAN
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Credential |
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Telephone | 857-310-3991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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