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Organization
GREEN LEAF GROWERS
Active
Organization
GREEN LEAF GROWERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPURGEON WAMALA (OFFICER)
(978) 726-3319
Entity
Organization
Contact information
Practice address
235 CHESTNUT ST FL 1, SPRINGFIELD, MA 01103-1103
(978) 726-3319
Mailing address
235 CHESTNUT ST LOWR LEVEL, SPRINGFIELD, MA 01103-1100
(978) 726-3319
Taxonomy
Speciality
Code
Description
License number
State
335G00000X
Medical Foods Supplier
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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