Organization
ONCOMED PHARMACEUTICAL SERVICES OF MA, LLC
Active
Other names
Onco360
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KONAK (VP, REVENUE CYCLE MGT)
(877) 662-6633
Entity
Organization
Contact information
Practice address
335 BEAR HILL RD STE 2100, WALTHAM, MA 02451-1006
(877) 662-6633
(877) 662-6355
Mailing address
13410 EASTPOINT CENTRE DR STE 100, LOUISVILLE, KY 40223-4160
(877) 662-6633
(502) 849-0643
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
DS89702
MA
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110084520
—
MA
Enumeration date
12/04/2009
Last updated
12/31/2025
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