| Pine Street Inn - Men's Clinic | |
|
444 Harrison Ave Boston MA 02118 | |
| (857) 654-1850 | |
| (857) 654-1433 |
| Full Name | Pine Street Inn - Men's Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 444 Harrison Ave, Boston, Massachusetts |
| Authorized Official Name and Position | Agnes W Leung (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8576541200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Street Inn - Men's Clinic 780 Albany St Boston MA 02118-2755 Ph: (857) 654-1227 | Pine Street Inn - Men's Clinic 444 Harrison Ave Boston MA 02118 Ph: (857) 654-1850 |
| NPI Number | 1205080348 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 05/24/2018 |
| Medicare PECOS PAC ID | 2668475419 |
|---|---|
| Medicare Enrollment ID | O20060816000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205080348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 4LQX (Massachusetts) | Primary |
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