Provider Demographics
NPI:1023049236
Name:THE GENERAL HOSPITAL CORPORATION
Entity type:Organization
Organization Name:THE GENERAL HOSPITAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:MASON
Authorized Official - Last Name:BOEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-724-4537
Mailing Address - Street 1:399 REVOLUTION DR
Mailing Address - Street 2:ASSEMBLY ROW 5 EAST 29-09
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1446
Mailing Address - Country:US
Mailing Address - Phone:857-282-7317
Mailing Address - Fax:617-726-6989
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:BULFINCH 360
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1001205Medicaid
MA2222007130OtherBCBS SDC
MA900043OtherHARVARD PILGRIM HEALTH CA
MA0006777OtherNHP CHARLESTOWN HEALTHCEN
MA1202154Medicaid
MA2222007110OtherBCBS OP
MA1202685Medicaid
MA1213997Medicaid
MA0007123OtherNHP OP
MA1202189Medicaid
MA1202197Medicaid
MA2222007101OtherBCBS IP
MA900166OtherTAHP OP
MA2222007116OtherBCBS HEALTHCENTERS
MA900017OtherTAHP IP
MA0007056OtherNHP IP
MA2222007130OtherBCBS SDC
MA2222007116OtherBCBS HEALTHCENTERS
MA1001205Medicaid
MA22S071Medicare Oscar/Certification