Healthcare Provider Details

I. General information

NPI: 1679715643
Provider Name (Legal Business Name): GREATER LAWRENCE FAMILY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PARK ST
LAWRENCE MA
01841-2517
US

IV. Provider business mailing address

1 GRIFFIN BROOK DR SUITE 101
METHUEN MA
01844-1865
US

V. Phone/Fax

Practice location:
  • Phone: 978-686-4453
  • Fax: 978-688-5849
Mailing address:
  • Phone: 978-686-0090
  • Fax: 978-722-3015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberDS89661
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ZANDRA S.W. KELLEY
Title or Position: CEO
Credential:
Phone: 978-686-0090