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General NPI Number Information
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NPI Number | 1134063449
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Entity Type | Organization
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Legal Business Name | CHARLES RIVER COMMUNITY HEALTH, INC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 43 FOUNDRY AVENUE SUITE 110
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City | WALTHAM
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State | MA
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Zip | 02453
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Country | US
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Telephone | 781-693-3895
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Fax |
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Provider Business Mailing Address
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Address Line | 495 WESTERN AVE
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City | BRIGHTON
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State | MA
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Zip | 02135-1007
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Country | US
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Telephone | 617-870-7448
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Fax | 617-870-7459
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Authorized Official
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Title or Position | CEO
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Name | MATTHEW LOCKWOOD MULLANEY
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Credential |
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Telephone | 617-783-0500
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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