Provider Demographics
NPI:1881231181
Name:THE COMMONWEALTH OF MASSACHUSETTS
Entity type:Organization
Organization Name:THE COMMONWEALTH OF MASSACHUSETTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-624-5246
Mailing Address - Street 1:250 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-4603
Mailing Address - Country:US
Mailing Address - Phone:617-624-6000
Mailing Address - Fax:617-624-5206
Practice Address - Street 1:305 SOUTH STREET
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3515
Practice Address - Country:US
Practice Address - Phone:617-983-6200
Practice Address - Fax:617-983-6211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMONWEALTH OF MASSACHUSETTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare