Organization
STEWARD ST ELIZABETHS MEDICAL CENTER OF BOSTON INC
Active
Other names
Brighton Marine Pharmacy at Hanscom
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GERMANO (PHARMACY DIRECTOR)
(617) 562-5302
Entity
Organization
Contact information
Practice address
1609 EGLIN ST, HANSCOM AFB, MA 01731-2613
(781) 274-9102
(781) 274-6249
Mailing address
1609 EGLIN ST, HANSCOM AFB, MA 01731-2613
(781) 274-9102
(781) 274-6249
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
MA0058861
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128072
PK
—
Enumeration date
08/05/2010
Last updated
11/19/2013
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