Provider Demographics
NPI:1689144982
Name:BRIGHAM & WOMENS HOSPITAL, INC.
Entity Type:Organization
Organization Name:BRIGHAM & WOMENS HOSPITAL, INC.
Other - Org Name:BRIGHAM AND WOMEN'S OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMRITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-724-9538
Mailing Address - Street 1:45 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6105
Mailing Address - Country:US
Mailing Address - Phone:617-732-6233
Mailing Address - Fax:
Practice Address - Street 1:45 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6105
Practice Address - Country:US
Practice Address - Phone:617-732-6233
Practice Address - Fax:617-732-4205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHAM & WOMEN'S HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-29
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1100220076PMedicaid