CODMAN SQUARE HEALTH CENTER – NPI #1003770736
Clinic/Center

CODMAN SQUARE HEALTH CENTER is an AHC clinic located in RANDOLPH, MA. NPPES has assigned the NPI number 1003770736 to CODMAN SQUARE HEALTH CENTER on December 16, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QC1500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Community Health

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CODMAN SQUARE HEALTH CENTER below.

NPI Profile for
CODMAN SQUARE HEALTH CENTER

NPI Number
1003770736
Enumeration Date

(about 6 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CODMAN SQUARE HEALTH CENTER
Primary location
42 HIGHLAND AVENUE
RANDOLPH, MA 02368-0000
Phone: (617) 825-9660 Fax: (617) 288-7898
Mailing address
637 WASHINGTON ST
DORCHESTER, MA 02124-3510
Phone: (617) 825-9660 Fax: (617) 288-7898
Organization Subpart
No
Authorized Official
GUY FISH
CEO
Phone: (617) 825-9660
Updated
Certification Date
Dec 15, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QC1500X
- Clinic/Center / Community Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.