Provider Demographics
NPI:1033854153
Name:BOSTON MEDICAL CENTER CORPORATION
Entity Type:Organization
Organization Name:BOSTON MEDICAL CENTER CORPORATION
Other - Org Name:BMC BROCKTON BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:T
Authorized Official - Last Name:NEWSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-638-8000
Mailing Address - Street 1:1 BOSTON MEDICAL CTR PL
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 N PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1708
Practice Address - Country:US
Practice Address - Phone:617-414-5393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
No282N00000XHospitalsGeneral Acute Care Hospital