Provider Demographics
NPI:1033242664
Name:ATRIUS HEALLTH, INC.
Entity Type:Organization
Organization Name:ATRIUS HEALLTH, INC.
Other - Org Name:HARVARD VANGUARD MEDICAL ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:THAO
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-629-6434
Mailing Address - Street 1:275 GROVE ST
Mailing Address - Street 2:BUILDING 2, 3RD FLOOR, SUITE 200
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02466-2272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 ESSEX CENTER DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2902
Practice Address - Country:US
Practice Address - Phone:978-977-4100
Practice Address - Fax:978-977-4055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATRIUS HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA00513613336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2229587OtherNCPDP
MA0402401Medicaid
MABH7452585OtherDEA #