# COMMONWEALTH MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
- **Other names:** CWM - Vaccine Program
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770142945
- **Legal business name:** UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
- **Authorized official:** ROSEMARIE BONAVENTURA (DEPUTY DIRECTOR)
- **Authorized official phone:** (617) 886-8013

## Contact information

- **Practice address:** 55 LAKE AVE N, WORCESTER, MA 01655-0002
- **Practice address phone:** (617) 886-8264
- **Mailing address:** 529 MAIN ST FL 3, CHARLESTOWN, MA 02129-1125
- **Mailing address phone:** (617) 886-8264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |
| 261QP0905X | State or Local Public Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/11/2019
- **Last updated:** 06/11/2019