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Organization
CAMBRIDGE PUBLIC HEALTH COMMISSION
Active
Organization
CAMBRIDGE PUBLIC HEALTH COMMISSION
Active
Other names
CAMBRIDGE HEALTH ALLIANCE OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA KOSSILOS BS IN PHARMACY (PHARMACY DIRECTOR)
(617) 806-8505
Entity
Organization
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1438
(617) 665-1148
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1438
(617) 665-1148
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3051
MA
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408506
—
MA
05
—
1211951
—
MA
01
—
2038790
PK
—
Enumeration date
12/29/2006
Last updated
11/23/2020
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