| NPI | 1831640408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LE Director 617-268-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: MA DS90257) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MA DS90257) |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MA DS90257) | |
| 3336C0004X Pharmacy Compounding Pharmacy (Licence: MA DS90257) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2021-04-09 |