Provider Demographics
NPI:1194242719
Name:BETH ISRAEL LAHEY HEALTH PHARMACY, INC.
Entity type:Organization
Organization Name:BETH ISRAEL LAHEY HEALTH PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP, CHIEF PHARMACY OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSENOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-352-6600
Mailing Address - Street 1:80 WILSON WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1806
Mailing Address - Country:US
Mailing Address - Phone:781-352-6600
Mailing Address - Fax:781-352-6610
Practice Address - Street 1:80 WILSON WAY
Practice Address - Street 2:SUITE B
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1806
Practice Address - Country:US
Practice Address - Phone:781-352-6600
Practice Address - Fax:781-352-6610
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH ISRAEL LAHEY HEALTH PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-24
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy