Provider Demographics
NPI:1518173871
Name:BERKSHIRE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BERKSHIRE MEDICAL CENTER, INC.
Other - Org Name:RENAL DIALYSIS SERVICES OF BMC
Other - Org Type:Other Name
Authorized Official - Title/Position:PROJECT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROMACKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-447-3442
Mailing Address - Street 1:PO BOX 4999
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-4999
Mailing Address - Country:US
Mailing Address - Phone:413-447-2000
Mailing Address - Fax:413-447-2803
Practice Address - Street 1:8 CONTE DR
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-8298
Practice Address - Country:US
Practice Address - Phone:413-447-2000
Practice Address - Fax:413-447-2803
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERKSHIRE MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-15
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAVQKK261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1200143Medicaid
10558OtherHEALTH NEW ENGLAND
MA2222004601OtherBLUE CROSS INPT
900201OtherTUFTS HEALTH PLAN OUTPT
220046OtherHUMANA
MA220046OtherUNICARE MA EMPLOYEE GIC
MA2222004630OtherBLUE CROSS SDC
900357OtherHARVARD PILGRIM HEALTH
0160OtherMVP
MA2222004610OtherBLUE CROSS OUTPT
905652OtherTUFTS HEALTH PLAN INPT
991396OtherCONNECTICARE
HO1478OtherOXFORD
260158OtherMAGELLAN BEHAVIORAL HEALT
MA1099981Medicaid
MA20300OtherBMC HEALTH NET PLAN
6300730OtherAETNA
10005746OtherCDPHP
900357OtherHARVARD PILGRIM HEALTH