Organization
SOUTH COVE COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC TIBERI (CEO)
(617) 521-6708
Entity
Organization
Contact information
Practice address
885 WASHINGTON ST, BOSTON, MA 02111-1415
(617) 482-7555
Mailing address
145 SOUTH ST, BOSTON, MA 02111-2826
(617) 521-6708
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4140
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M17997
BLUE CROSS
—
Enumeration date
11/01/2007
Last updated
04/06/2026
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