Organization
MASS GENERAL WALTHAM
Active
Parent organization
THE GENERAL HOSPITAL CORPORATION
Other names
General Hospital Corp
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE GENERAL HOSPITAL CORPORATION
Authorized official
SALLY MASON BOEMER (EVP OF ADMINISTRATION & FINANCE)
(617) 724-4537
Entity
Organization
Contact information
Practice address
52 SECOND AVE FL 4, WALTHAM, MA 02451-1127
(781) 487-4390
(781) 487-4391
Mailing address
55 FRUIT ST, GRB05-ATTENTION KAREN RYLE, BOSTON, MA 02114-2621
(781) 487-4390
(781) 487-4391
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MA0049076
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0447641
—
MA
Enumeration date
10/02/2006
Last updated
08/31/2022
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