Provider Demographics
NPI:1306567938
Name:BETH ISRAEL LAHEY HEALTH PHARMACY, INC
Entity type:Organization
Organization Name:BETH ISRAEL LAHEY HEALTH PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SPECIALTY PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CATTANEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-352-6504
Mailing Address - Street 1:80 WILSON WAY STE B
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1806
Mailing Address - Country:US
Mailing Address - Phone:781-352-6504
Mailing Address - Fax:781-352-6610
Practice Address - Street 1:80 WILSON WAY STE B
Practice Address - Street 2:
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:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADS90335OtherMASSACHUSETTS DRUG STORE PERMIT ID