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Organization

SOUTH BOSTON COMMUNITY HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIM TRACY HARRISON (CFO)
(617) 464-7460
Entity
Organization

Contact information

Practice address
409 W BROADWAY, SOUTH BOSTON, MA 02127-2245
(617) 269-7500
(617) 464-7512
Mailing address
409 W BROADWAY, SOUTH BOSTON, MA 02127-2245
(617) 269-7500
(617) 464-7512

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CB9679
RAILROAD MEDICARE
Enumeration date
02/22/2006
Last updated
01/30/2026
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