Provider Demographics
NPI:1295182301
Name:CAMBRIDGE PUBLIC HEALTH COMMISSION
Entity Type:Organization
Organization Name:CAMBRIDGE PUBLIC HEALTH COMMISSION
Other - Org Name:CAMBRIDGE HEALTH ALLIANCE OUTPATIENT PHARMACY MALDEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE CHIEF PHARMACY OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSSILOS
Authorized Official - Suffix:
Authorized Official - Credentials:BS IN PHARMACY
Authorized Official - Phone:617-806-8505
Mailing Address - Street 1:195 CANAL ST
Mailing Address - Street 2:ATTN: OUTPATIENT PHARMACY
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-6701
Mailing Address - Country:US
Mailing Address - Phone:781-338-8990
Mailing Address - Fax:781-338-8991
Practice Address - Street 1:195 CANAL ST
Practice Address - Street 2:ATTN: OUTPATIENT PHARMACY
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-6701
Practice Address - Country:US
Practice Address - Phone:781-338-8990
Practice Address - Fax:781-338-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy