Provider Demographics
NPI:1730321332
Name:BOSTON WOMAN'S HOSPITAL
Entity type:Organization
Organization Name:BOSTON WOMAN'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-410-9138
Mailing Address - Street 1:3 ALLIED DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6122
Mailing Address - Country:US
Mailing Address - Phone:781-710-9138
Mailing Address - Fax:
Practice Address - Street 1:3 ALLIED DR
Practice Address - Street 2:SUITE 303
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6122
Practice Address - Country:US
Practice Address - Phone:781-710-9138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization