Organization
BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON M RADZEVICH (V. P. OF FINANCE AND CFO)
(508) 830-2005
Entity
Organization
Contact information
Practice address
275 SANDWICH ST, PLYMOUTH, MA 02360-2183
(508) 746-2000
(508) 830-1131
Mailing address
275 SANDWICH ST, PLYMOUTH, MA 02360-2183
(508) 746-2000
(508) 830-1131
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
2082
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020545
BMC HEALTHNET
MA
05
—
1213326
—
MA
01
—
220060
MEDICARE PTAN
MA
01
—
2222006010
BCBS MA OUTPATIENT
MA
01
—
2222006030
BCBS MA SDC
MA
01
—
500444
TUFTS MENTAL HLTH OUTPATI
MA
01
—
614592
TUFTS CLINIC
MA
01
—
687428
TUFTS OCCUPATIONAL HEALTH
MA
01
—
900002
HARVARD PILGRIM
MA
01
—
903132
TUFTS OUTPATIENT
MA
01
—
S012236
CHAMPUS
MA
Enumeration date
08/22/2006
Last updated
03/23/2021
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