FENWAY COMMUNITY HEALTH CENTER INC NPI 1003804725

NPI Information

NPI: 1003804725
Provider Name: FENWAY COMMUNITY HEALTH CENTER, INC

Doing Business As: FENWAY HEALTH

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1340 BOYLSTON ST
BOSTON, MA
ZIP 02215
Phone: (617) 927-4880
Get Directions

FENWAY COMMUNITY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Boston, MA. FENWAY COMMUNITY HEALTH CENTER, INC NPI is 1003804725. The provider is registered as an organization entity type.
The provider Is Doing Business As Fenway Health.

The provider's business location address is:

1340 BOYLSTON ST
BOSTON, MA
ZIP 02215-302
Phone: (617) 927-4880

The provider's authorized official is Jeff Lieberman .
The authorized official title is Vp Finance & Administration and has the following contact phone number (617) 927-6173.

The enumeration date for this NPI number is 10/6/2005 and was last updated on 7/7/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	4519	MASSACHUSETTS	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	4519	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1303546	MEDICAID	MASSACHUSETTS
2	Y10138	MEDICARE PIN	MASSACHUSETTS
3	221867	MEDICARE OSCAR/CERTIFICATION	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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