Provider Demographics
NPI:1821042268
Name:RADIUS SPECIALTY HOSPITAL LLC
Entity Type:Organization
Organization Name:RADIUS SPECIALTY HOSPITAL LLC
Other - Org Name:RADIUS SPECIALTY HOSPITAL - BOSTON
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-989-8448
Mailing Address - Street 1:59 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1318
Mailing Address - Country:US
Mailing Address - Phone:617-989-8400
Mailing Address - Fax:617-989-8301
Practice Address - Street 1:59 TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1318
Practice Address - Country:US
Practice Address - Phone:617-989-8400
Practice Address - Fax:617-989-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2132281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1100581Medicaid
MA222010Medicare ID - Type Unspecified