Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Parent organization
THE COMMONWEALTH OF MASSACHUSETTS
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Authorized official
MR. CULLEN ROBERTS (CHIEF FINANCIAL OFFICER)
(617) 624-5626
Entity
Organization
Contact information
Practice address
305 SOUTH STREET, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH-IMMUNIZATION, JAMAICA PLAIN, MA 02130
(617) 983-6800
(617) 983-6840
Mailing address
305 SOUTH STREET, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH-IMMUNIZATION, JAMAICA PLAIN, MA 02130
(617) 983-6800
(617) 983-6840
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/12/2007
Last updated
10/25/2017
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