Provider Demographics
NPI:1033274295
Name:THE CANCER CENTER OF BOSTON, INC.
Entity Type:Organization
Organization Name:THE CANCER CENTER OF BOSTON, INC.
Other - Org Name:THE CANCER CENTER INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLETTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-739-6605
Mailing Address - Street 1:830 BOYLSTON ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2503
Mailing Address - Country:US
Mailing Address - Phone:617-735-6605
Mailing Address - Fax:617-739-4819
Practice Address - Street 1:830 BOYLSTON ST
Practice Address - Street 2:SUITE 209
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2503
Practice Address - Country:US
Practice Address - Phone:617-735-6605
Practice Address - Fax:617-739-4819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8000OtherCIGNA HEALTHSOURCE
22286OtherFALLON COMM. HEALTH PLAN
S015002OtherTRICARE CHAMPUS
MA9763147Medicaid
0092501OtherAETNA US HEALTHCARE
30004225OtherNEW HAMPSHIRE MEDICAID
718250OtherTUFTS
0092501OtherAETNA US HEALTHCARE
718250OtherTUFTS