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General NPI Number Information
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NPI Number | 1144740317
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Entity Type | Organization
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Legal Business Name | MASS GENERAL BRIGHAM SPECIALTY PHARMACY, INC.
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 31 NORTH AVE
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City | BURLINGTON
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State | MA
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Zip | 01803-3305
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Country | US
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Telephone | 877-468-8717
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Fax |
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Provider Business Mailing Address
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Address Line | 31 NORTH AVE
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City | BURLINGTON
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State | MA
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Zip | 01803-3305
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Country | US
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Telephone | 877-468-8717
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Fax | 857-238-2135
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICHAEL CARTER
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Credential |
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Telephone | 857-238-2107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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