Provider Demographics
NPI:1700982592
Name:CHILDREN'S HOSPITAL CORPORATION
Entity type:Organization
Organization Name:CHILDREN'S HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP FINANCE AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIRSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-355-6881
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:PATIENT FINANCIAL SERVICES ATN STEVEN NICOLL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-4831
Mailing Address - Fax:617-730-0080
Practice Address - Street 1:75 BICKFORD ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-1401
Practice Address - Country:US
Practice Address - Phone:617-355-4831
Practice Address - Fax:617-730-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2139251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE10038OtherBLUE CROSS BLUE SHEILD
MA613436OtherTUFTS HEALTH PLAN
MA623879OtherHARVARD PILGRIM HEALTH PL
MA000000006560OtherBOSTON MEDICAL CTR HEALTH
MA0009150OtherNEIGHBORHOOD HELATH PLAN
MA1803212Medicaid