| Signature Healthcare Brockton Hospital | |
|
680 Centre St Brockton MA 02302-3308 | |
| (508) 941-7062 | |
| (508) 941-6337 |
| Full Name | Signature Healthcare Brockton Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 680 Centre St, Brockton, Massachusetts |
| Authorized Official Name and Position | Eugene C. Wallace (CEO) |
| Authorized Official Contact | 5089417062 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Signature Healthcare Brockton Hospital Po Box 847493 Boston MA 02284-7493 Ph: (508) 565-0147 | Signature Healthcare Brockton Hospital 680 Centre St Brockton MA 02302-3308 Ph: (508) 941-7062 |
| NPI Number | 1174560304 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 12/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174560304 | NPI | - | NPPES |
| 9757350 | Medicaid | MA | |
| M19115 | Other | MA | BCBS GROUP # |
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