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General NPI Number Information
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NPI Number | 1790412716
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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 | 08/02/2022
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Last Update Date | 12/26/2024
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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 | 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 | 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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