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
—
—
3336C0002X
Clinic Pharmacy
—
—
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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