Organization

South Boston Community Health Center

Clinic/Center in South Boston, MA(View on Map)

Legal Business Name

South Boston Community Health Center

NPI Number

1366626624

NPI Type

Organization

Enumeration Date

12/21/2007

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

409 W BROADWAY
409 W BROADWAY

City

South Boston
South Boston

State

MA
MA

Postal Code

02127-2245
02127-2245

Country

US
US

Telephone Number

(617) 269-7500
(617) 269-7500

Authorized Official

Name

Akinola Ogungbadero

Title or Position

CFO

Telephone Number

(617) 269-7500

Identifiers

Identifier

X10787

Identifier State

MA

Identifier Issuer

BLUE CROSS DENTAL

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/21/2007

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