=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528996071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY HEALTH CENTER OF WORCESTER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2026
-----------------------------------------------------
Last Update Date | 05/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26 QUEEN STREET PHARMACY
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01610-2473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-860-7730
-----------------------------------------------------
Fax | 508-860-7737
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26 QUEEN STREET PHARMACY
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01610-2473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-860-7730
-----------------------------------------------------
Fax | 508-860-7737
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MRG. PROVIDER RELATIONS
-----------------------------------------------------
Name | ALYDA JUSTINIANO-FRANZEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-860-7962
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------