Provider Demographics
NPI:1528328861
Name:BERKSHIRE MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:BERKSHIRE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-447-2000
Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:PO BOX 4999
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4109
Mailing Address - Country:US
Mailing Address - Phone:413-447-2000
Mailing Address - Fax:413-447-2803
Practice Address - Street 1:10 MAPLE ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1128
Practice Address - Country:US
Practice Address - Phone:413-854-9910
Practice Address - Fax:413-854-9911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERKSHIRE MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-21
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAVQKK261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0160OtherMVP
MAH01478OtherOXFORD
MA10558OtherHEALTH NEW ENGLAND
MA1200143Medicaid
MA905652OtherTUFTS INPATIENT
MA000000020300OtherBMC HEALTH NET PLAN
MA10005746OtherCDPHP IN PATIENT
MA2222004630OtherBLUE CROSS SDC
MA900201OtherTUFTS OUTPATIENT
MA900357OtherHARVARD PILGRIM
MA220046OtherUNICARE MA EMPLOYEE GIC
MA10005746OtherCDPHP OUT PATIENT
MA2222004610OtherBLUE CROSS OUT PATIENT
MA991396OtherCONNECTICARE
MA2222004601OtherBLUE CROSS INPATIENT
MD1099981Medicaid
MA6300730OtherAETNA
MA220046OtherUNICARE MA EMPLOYEE GIC