| Codman Square Health Center | |
|
637 Washington Street Dorchester MA 02124-3510 | |
| (617) 825-9660 | |
| (617) 288-7898 |
| Full Name | Codman Square Health Center |
|---|---|
| Speciality | Clinic/center |
| Location | 637 Washington Street, Dorchester, Massachusetts |
| Authorized Official Name and Position | Trudy Griffin (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 6178228382 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Codman Square Health Center 637 Washington St Dorchester MA 02124-3510 Ph: (617) 825-9660 | Codman Square Health Center 637 Washington Street Dorchester MA 02124-3510 Ph: (617) 825-9660 |
| NPI Number | 1487844726 |
|---|---|
| Provider Enumeration Date | 08/01/2007 |
| Last Update Date | 03/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487844726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | V112 (Massachusetts) | Primary |
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