Provider Demographics
NPI:1669770368
Name:SOUTH SHORE HEALTH CARE, INC.
Entity type:Organization
Organization Name:SOUTH SHORE HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SEARS
Authorized Official - Last Name:BARATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-848-1950
Mailing Address - Street 1:759 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5328
Mailing Address - Country:US
Mailing Address - Phone:781-848-1950
Mailing Address - Fax:781-356-4887
Practice Address - Street 1:759 GRANITE ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5328
Practice Address - Country:US
Practice Address - Phone:781-848-1950
Practice Address - Fax:781-356-4887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000033640OtherBMC HEALTHNET PLAN
M15468OtherMEDICARE
600659OtherTUFTS HEALTH PLAN
MA110071828AMedicaid
MAM15468OtherBCBSMA
0463966OtherAETNA
0957512OtherCIGNA