Healthcare Provider Details

I. General information

NPI: 1508524075
Provider Name (Legal Business Name): TUFTS MEDICINE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 GOVERNORS AVE
MEDFORD MA
02155-1643
US

IV. Provider business mailing address

800 DISTRICT AVE STE 520
BURLINGTON MA
01803-5057
US

V. Phone/Fax

Practice location:
  • Phone: 978-942-2156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERICA DIAMANTIDES
Title or Position: VP AMBULATORY PHARMACY
Credential:
Phone: 617-636-5787