Provider Demographics
NPI:1053635441
Name:CHILDRENS HOSPITAL CORPORATION
Entity type:Organization
Organization Name:CHILDRENS 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 ATTN STEVEN NICOLL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:857-218-3391
Mailing Address - Fax:617-730-0080
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:PATIENT FINANCIAL SERVICES ATTN STEVEN NICOLL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:857-218-3391
Practice Address - Fax:617-730-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
458829052OtherCIGNA
6300175OtherAETNA
MA110026858BMedicaid
MA2222012201OtherBLUE CROSS INPATIENT
MA900018OtherHPHC
MA0007052OtherNHP
MA2222012210OtherBLUE CROSS OUTPT
MA2222012230OtherBLUE CROSS DSUOBS
MA6561OtherBMC
MA643120OtherTUFTS RADIOLOGIST
MA110026858AMedicaid
458829052OtherCIGNA