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Organization
CHARLES RIVER COMMUNITY HEALTH CENTER
Active
Organization
CHARLES RIVER COMMUNITY HEALTH CENTER
Active
Other names
Charles River Community Health
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LOCKWOOD MULLANEY (CEO)
(617) 783-0500
Entity
Organization
Contact information
Practice address
43 FOUNDRY AVE STE 110, WALTHAM, MA 02453-8313
(781) 693-3873
(781) 693-3810
Mailing address
43 FOUNDRY AVE, WALTHAM, MA 02453-8313
(781) 693-3873
(781) 693-3810
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
DS90057
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10024306S
—
MA
01
—
2134273
PK
—
Enumeration date
03/29/2012
Last updated
04/14/2026
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