MEDICARE: BIOMEDICAL LABORATORIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	2427	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	701421	OTHER	MD	TUFTS HEALTH PLAN
2	9724627	OTHER	MA	CIGNA
3	11470212	OTHER	MA	CAQH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	228400	OTHER	MA	BLUE CROSS BLUE SHIELD
6	0008779	OTHER	MA	CHILDREN'S MEDICAL
7	800345	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1306867981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOMEDICAL LABORATORIES

Provider Business Mailing Address
First Line	:	480 WASHINGTON ST
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2655
Country	:	US
Telephone Number	:	617-783-0600
Fax Number	:	617-783-0602

Provider Business Practice Location Address
First Line	:	480 WASHINGTON ST
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2655
Country	:	US
Telephone Number	:	617-783-0600
Fax Number	:	617-783-0602

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	DR. APPU K. PILLAI
Credential	:	PHD
Telephone Number	:	617-783-0600

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/01/2009

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Directions to “BIOMEDICAL LABORATORIES ” Practice Location

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