Provider Demographics
NPI:1386185775
Name:BOSTON MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:BOSTON MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AHTSHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-862-0989
Mailing Address - Street 1:60 STATE ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-1800
Mailing Address - Country:US
Mailing Address - Phone:617-862-0989
Mailing Address - Fax:617-399-6679
Practice Address - Street 1:60 STATE ST
Practice Address - Street 2:SUITE 700
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1800
Practice Address - Country:US
Practice Address - Phone:617-862-0989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies