# BOSTON CBOC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366495558
- **Authorized official:** BARBARA MAYERICK (DIRECTOR, BUSINESS DEVELOPMENT)
- **Authorized official phone:** (202) 254-0339

## Contact information

- **Practice address:** 150 S HUNTINGTON AVE, JAMAICA PLAIN, MA 02130-4817
- **Practice address phone:** (617) 232-9500
- **Practice address fax:** (617) 278-4549
- **Mailing address:** 150 S HUNTINGTON AVE, JAMAICA PLAIN, MA 02130-4817
- **Mailing address phone:** (617) 232-9500
- **Mailing address fax:** (617) 278-4549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 08/07/2008