Organization
CODMAN SQUARE HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GUY FISH CEO (CHIEF EXECUTIVE OFFICER)
(617) 825-9660
Entity
Organization
Contact information
Practice address
637 WASHINGTON ST, DORCHESTER CENTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110022129F
—
MA
05
—
1211757
—
MA
Enumeration date
12/19/2006
Last updated
03/26/2026
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