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General NPI Number Information
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NPI Number | 1275200461
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Entity Type | Organization
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Legal Business Name | EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 354 WAVERLEY ST FL 3
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City | FRAMINGHAM
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State | MA
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Zip | 01702-7079
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Country | US
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Telephone | 800-853-2288
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Fax |
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Provider Business Mailing Address
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Address Line | 115 NE CUTOFF STE 200
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City | WORCESTER
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State | MA
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Zip | 01606-1224
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Country | US
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Telephone | 508-532-7315
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, HUMAN RESOURCES
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Name | DAVID SMALL
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Credential |
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Telephone | 508-532-7315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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