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General NPI Number Information
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NPI Number | 1053626283
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Entity Type | Organization
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Legal Business Name | STEWARD ST ELIZABETHS MEDICAL CENTER OF BOSTON INC
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 77 WARREN ST PHCY DEPT
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City | BRIGHTON
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State | MA
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Zip | 02135-3601
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Country | US
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Telephone | 617-562-5304
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Fax | 617-562-5296
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Provider Business Mailing Address
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Address Line | 77 WARREN ST PHCY DEPT
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City | BRIGHTON
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State | MA
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Zip | 02135-3682
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Country | US
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Telephone | 617-562-5304
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Fax | 617-562-5296
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | JAMES GERMANO
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Credential |
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Telephone | 617-562-5302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | MA0058873
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License Number State | MA
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