# CARITAS ST ELIZABETH HEALTH CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BRIGHTON MARINE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043359854
- **Authorized official:** JAMES GERMANO RPH (PHCY MGR)
- **Authorized official phone:** (617) 562-5302

## Contact information

- **Practice address:** 77 WARREN ST, PHCY DEPT, BRIGHTON, MA 02135-3601
- **Practice address phone:** (617) 562-5304
- **Practice address fax:** (617) 562-5296
- **Mailing address:** 77 WARREN ST, PHCY DEPT, BRIGHTON, MA 02135-3601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336M0003X | Managed Care Organization Pharmacy | MA0148848 | MA | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 09/12/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0401200 | — | MA |
| 01 | — | 2226175 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |