Organization
CARITAS GOOD SAMARITAN MEDICAL CENTER-DIAGNOSTIC FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL BURNS (EXECUTIVE DIRECTOR)
(508) 427-2217
Entity
Organization
Contact information
Practice address
1 PEARL ST, BROCKTON, MA 02301-2864
(508) 427-3668
Mailing address
77 WARREN STREET, PROVIDER ENROLLMENT DEPT, BRIGHTON, MA 02135
(617) 562-5482
(617) 562-5359
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1210009
—
MA
Enumeration date
10/05/2006
Last updated
08/22/2020
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