Organization
BAYSTATE MEDICAL CENTER, INC.
Active
Other names
BAYSTATE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GARY KERR PHARMD (CHIEF PHARMACY OFFICER)
(413) 794-3178
Entity
Organization
Contact information
Practice address
50 WASON AVE, SPRINGFIELD, MA 01107-1132
(413) 794-9009
(413) 794-9013
Mailing address
50 WASON AVE, SPRINGFIELD, MA 01107-1274
(413) 794-9009
(413) 794-9013
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
DS89896
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS89896
CONTROLLED SUBSTANCE REGISTRATION
MA
01
—
DS89896
MA DRUG STORE NUMBER
MA
Enumeration date
12/12/2013
Last updated
03/07/2023
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