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General NPI Number Information
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NPI Number | 1669393682
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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 | 07/24/2026
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Last Update Date | 07/24/2026
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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 | 508-408-9320
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Fax | 857-241-5492
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Provider Business Mailing 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 | 508-408-9320
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Fax | 857-241-5492
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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