Provider Demographics
NPI:1285303354
Name:CAMBRIDGE PUBLIC HEALTH COMMISSION
Entity type:Organization
Organization Name:CAMBRIDGE PUBLIC HEALTH COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, AMB PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HANLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-806-8509
Mailing Address - Street 1:350 MAIN ST STE 640
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5089
Mailing Address - Country:US
Mailing Address - Phone:781-338-0670
Mailing Address - Fax:781-338-0690
Practice Address - Street 1:350 MAIN ST STE 640
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5089
Practice Address - Country:US
Practice Address - Phone:781-338-0670
Practice Address - Fax:781-338-0690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy