Provider Demographics
NPI:1104437896
Name:DANA-FARBER CANCER INSTITUTE, INC.
Entity type:Organization
Organization Name:DANA-FARBER CANCER INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIALTY PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:POQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:508-234-4366
Mailing Address - Street 1:300 BOYLSTON ST STE 310
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 BOYLSTON ST STE 310
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1959
Practice Address - Country:US
Practice Address - Phone:617-632-3878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANA-FARBER CANCER INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-14
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy