Organization
FENWAY COMMUNITY HEALTH CENTER, INC
Active
Parent organization
FENWAY HEALTH OPTOMETRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
FENWAY HEALTH OPTOMETRY
Authorized official
MS. KARA ROBERTS (ADMINISTRATIVE MANAGER)
(617) 927-6479
Entity
Organization
Contact information
Practice address
1340 BOYLSTON ST, 6TH FLOOR, BOSTON, MA 02215-4302
(617) 927-6479
(617) 927-6150
Mailing address
1340 BOYLSTON ST, 6TH FLOOR, BOSTON, MA 02215-4302
(617) 927-6479
(617) 927-6150
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110020739B
—
MA
Enumeration date
07/30/2009
Last updated
07/30/2009
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