1053635441 NPI number — CHILDRENS HOSPITAL CORPORATION

Table of content: (NPI 1053635441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053635441 NPI number — CHILDRENS HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDRENS HOSPITAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CHILDRENS HOSPITAL RADIOLOGY PFS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053635441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 LONGWOOD AVE
Provider Second Line Business Mailing Address:
PATIENT FINANCIAL SERVICES ATTN STEVEN NICOLL
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02115-5724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-218-3391
Provider Business Mailing Address Fax Number:
617-730-0080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 LONGWOOD AVE
Provider Second Line Business Practice Location Address:
PATIENT FINANCIAL SERVICES ATTN STEVEN NICOLL
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-218-3391
Provider Business Practice Location Address Fax Number:
617-730-0080
Provider Enumeration Date:
03/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KIRSHNER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
A
Authorized Official Title or Position:
SR VP FINANCE AND CFO
Authorized Official Telephone Number:
617-355-6881

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 458829052 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6300175 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110026858B , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2222012201 . This is a "BLUE CROSS INPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900018 . This is a "HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007052 . This is a "NHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222012210 . This is a "BLUE CROSS OUTPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222012230 . This is a "BLUE CROSS DSUOBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 6561 . This is a "BMC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 643120 . This is a "TUFTS RADIOLOGIST" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110026858A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com