The Commonwealth of Massachusetts
NPI #1093856965 in Jamaica Plain, Massachusetts
Provider Information
- NPI Number
- 1093856965
- Entity Type
- Organization
- Organization Name
- The Commonwealth of Massachusetts
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- THE COMMONWEALTH OF MASSACHUSETTS
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Feb 12, 2007
- Last Updated
- Oct 25, 2017
Practice Location
- Address
- 305 SOUTH STREET
- Address 2
- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH-IMMUNIZATION
- City
- Jamaica Plain
- State
- Massachusetts
- ZIP Code
- 02130
- Phone
- (617) 983-6800
Authorized Official
- Name
- MR. CULLEN ROBERTS
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (617) 624-5626
Specialties & Taxonomy Codes
| Specialty |
|---|
| Public Health or Welfare |
| Clinical Medical Laboratory |
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