MEDICARE: ASTRAZENECA LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center		MA

General Provider Information

NPI Number	:	1861726937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRAZENECA LP

Provider Business Mailing Address
First Line	:	35 GATEHOUSE DR
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-1215
Country	:	US
Telephone Number	:	781-839-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 GATEHOUSE DR
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-1215
Country	:	US
Telephone Number	:	781-839-4000
Fax Number	:

Authorized Official
Title or Position	:	SITE GENERAL MANAGER
Name	:	JOHN HENNESSEY
Credential	:
Telephone Number	:	781-839-4504

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	09/23/2009

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Directions to “ASTRAZENECA LP ” Practice Location

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