Provider Demographics
NPI:1659436996
Name:BERKSHIRE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BERKSHIRE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-447-2000
Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:PO BOX 4999
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4109
Mailing Address - Country:US
Mailing Address - Phone:413-447-2000
Mailing Address - Fax:413-447-2803
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
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:2006-12-27
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAVQKK273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
10558OtherHEALTH NEW ENGLAND
MA20300OtherBMC HEALTH NET PLAN
220046OtherHUMANA
0160OtherMVP HEALTH PLAN
MA1200143Medicaid
MA220046OtherUNICARE MA EMPLOYEE GIC
10005746OtherCDPHP
260158OtherMAGELLAN BEHAVIORAL HEALT
6300730OtherAETNA
MA2222004601OtherBLUE CROSS INPT
MA2222004630OtherBLUE CROSS SDC
900357OtherHARVARD PILGRIM HEALTH
MA1099981Medicaid
MA2222004610OtherBLUE CROSS OUTPT
900201OtherTUFTS HEALTH PLAN OUTPT
905652OtherTUFTS HEALTH PLAN INPT
991396OtherCONNECTICARE
HO1478OtherOXFORD
900201OtherTUFTS HEALTH PLAN OUTPT