| Massachusetts General Hospital Clinic | |
|
55 Fruit St Wacc 108 Boston MA 02114 | |
| (617) 726-2707 | |
| (617) 724-0189 |
| Full Name | Massachusetts General Hospital Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 55 Fruit St, Boston, Massachusetts |
| Authorized Official Name and Position | Agnes W Leung (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8576541200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Massachusetts General Hospital Clinic 780 Albany St Boston MA 02118-2755 Ph: (857) 654-1227 | Massachusetts General Hospital Clinic 55 Fruit St Wacc 108 Boston MA 02114 Ph: (617) 726-2707 |
| NPI Number | 1245473859 |
|---|---|
| Provider Enumeration Date | 04/13/2009 |
| Last Update Date | 05/23/2018 |
| Medicare PECOS PAC ID | 2668475419 |
|---|---|
| Medicare Enrollment ID | O20080718000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245473859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 4LQX (Massachusetts) | Primary |
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