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General NPI Number Information
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NPI Number | 1881801868
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Entity Type | Organization
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Legal Business Name | SAINT ELIZABETH MEDICAL CENTER DIALYSIS UNIT
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 736 CAMBRIDGE ST
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City | BRIGHTON
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State | MA
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Zip | 02135-2907
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Country | US
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Telephone | 800-664-3884
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50664
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City | WOBURN
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State | MA
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Zip | 01815-0001
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Country | US
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Telephone | 800-664-3884
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. DAVID OSLUND
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Credential |
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Telephone | 800-664-3884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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