Provider Demographics
NPI:1205948973
Name:BERKSHIRE MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:BERKSHIRE MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-447-2809
Mailing Address - Street 1:PO BOX 2309
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-2309
Mailing Address - Country:US
Mailing Address - Phone:413-447-2862
Mailing Address - Fax:413-447-2869
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-447-2862
Practice Address - Fax:413-447-2869
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERKSHIRE MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAVQKK251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110122OtherBLUE SHIELD
MA0602515Medicaid
MA0608726Medicaid
MA0602515Medicaid