MEDICARE: PARTNERS OF MASSACHUSETTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy	3419	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2241153	OTHER		NCPDP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3419	OTHER	MA	MA PHARMACY LICENSE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508897695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS OF MASSACHUSETTS, LLC

Provider Business Mailing Address
First Line	:	181 CEDAR HILL ST
Second Line	:	SUITE 1
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-3035
Country	:	US
Telephone Number	:	508-624-8880
Fax Number	:	508-624-8890

Provider Business Practice Location Address
First Line	:	181 CEDAR HILL ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-3035
Country	:	US
Telephone Number	:	508-624-8880
Fax Number	:	508-624-8890

Authorized Official
Title or Position	:	COO
Name	:	JAMES MATTHEWS
Credential	:
Telephone Number	:	609-206-2664

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/06/2023

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