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General NPI Number Information
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NPI Number | 1477372027
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE MEDICAL CENTER
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 70 PLEASANT ST
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City | SOUTH WEYMOUTH
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State | MA
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Zip | 02190-2427
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Country | US
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Telephone | 781-331-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 141 LONGWATER DR STE 201
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City | NORWELL
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State | MA
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Zip | 02061-1621
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Country | US
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Telephone | 781-681-0384
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Fax | 781-681-1384
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SUPERVISOR
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Name | JACLYN VALANZOLA
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Credential |
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Telephone | 781-681-0384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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