Provider Demographics
NPI:1336635614
Name:BETH ISRAEL LAHEY HEALTH PHARMACY, INC.
Entity Type:Organization
Organization Name:BETH ISRAEL LAHEY HEALTH PHARMACY, INC.
Other - Org Name:BILH PHARMACY, 364 BROOKLINE AVE, BOSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP, CHIEF PHARMACY OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSENOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-667-6200
Mailing Address - Street 1:364 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5401
Mailing Address - Country:US
Mailing Address - Phone:617-667-6200
Mailing Address - Fax:617-667-6199
Practice Address - Street 1:364 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5401
Practice Address - Country:US
Practice Address - Phone:617-667-6200
Practice Address - Fax:617-667-6199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH ISRAEL LAHEY HEALTH PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-10
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADS902563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy