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General NPI Number Information
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NPI Number | 1164967659
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Entity Type | Organization
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Legal Business Name | GREATER LAWRENCE FAMILY HEALTH CENTER INC
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Dates
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Enumeration Date | 12/20/2016
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 73D WINTHROP AVE
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City | LAWRENCE
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State | MA
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Zip | 01843-3716
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Country | US
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Telephone | 978-689-6790
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Fax | 978-975-3727
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Provider Business Mailing Address
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Address Line | 1 GRIFFIN BROOK DR SUITE 101
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City | METHUEN
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State | MA
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Zip | 01844-1865
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Country | US
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Telephone | 978-725-7400
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Fax | 978-722-3015
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Authorized Official
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Title or Position | CEO
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Name | ZANDRA S.W. KELLEY
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Credential |
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Telephone | 978-686-0090
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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 | DS90069
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License Number State | MA
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