| Fenway Community Health Center, Inc | |
|
75 Kneeland St 2nd Floor Boston MA 02111-1901 | |
| (617) 457-8140 | |
| (617) 457-8141 |
| Full Name | Fenway Community Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 75 Kneeland St, Boston, Massachusetts |
| Authorized Official Name and Position | Jeffrey M Lieberman (VP FINANACE & ADMINISTRATION) |
| Authorized Official Contact | 6179276173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fenway Community Health Center, Inc 1340 Boylston St Boston MA 02215-4302 Ph: (617) 927-6173 | Fenway Community Health Center, Inc 75 Kneeland St 2nd Floor Boston MA 02111-1901 Ph: (617) 457-8140 |
| NPI Number | 1548589047 |
|---|---|
| Provider Enumeration Date | 05/24/2010 |
| Last Update Date | 09/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548589047 | NPI | - | NPPES |
| 110024430F | Medicaid | MA |
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