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Organization
BAYSTATE PHARMACY
Active
Organization
BAYSTATE PHARMACY
Active
Parent organization
BAYSTATE MEDICAL CENTER INC
Other names
Baystate Medical Center Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYSTATE MEDICAL CENTER INC
Authorized official
DR. GARY JAMES KERR (CHIEF PHARMACY OFFICER)
(413) 794-3178
Entity
Organization
Contact information
Practice address
50 WASON AVE, SPRINGFIELD, MA 01107-1132
(413) 794-9009
(413) 794-9013
Mailing address
PO BOX 798, SPRINGFIELD, MA 01101-0798
(413) 794-9009
(413) 794-9013
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
DS89896
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS89896
CONTROLLED SUBSTANCE REGISTRATION
MA
01
—
DS89896
MA DRUG STORE NUMBER
MA
Enumeration date
04/17/2014
Last updated
03/07/2023
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