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DIMOCK COMMUNITY HEALTH CENTER NPI 1336563188


NPI Information

NPI: 1336563188
Provider Name: DIMOCK COMMUNITY HEALTH CENTER

Doing Business As: THE DIMOCK CENTER

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

CLIA Number: 22D0880623

Address:
55 DIMOCK ST
CREDENTIALING OFFICE
ROXBURY, MA
ZIP 02119
Phone: (617) 442-8800
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DIMOCK COMMUNITY HEALTH CENTER is a community health clinic center in Roxbury, MA. DIMOCK COMMUNITY HEALTH CENTER NPI is 1336563188. The provider is registered as an organization entity type.
The provider Is Doing Business As The Dimock Center.

The provider's business location address is:

55 DIMOCK ST
CREDENTIALING OFFICE
ROXBURY, MA
ZIP 02119-029
Phone: (617) 442-8800
Fax: (617) 427-2784

The provider's authorized official is Kerlley Aime' .
The authorized official title is Credentialing Coordinator and has the following contact phone number (617) 442-8800.

The CLIA number assigned to this NPI record is 22D0880623 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/14/2014 and was last updated on 2/14/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QC1500XClinic/CenterCommunity HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1M21066OTHERMASSACHUSETTSMEDICARE PTAN

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

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