Provider Demographics
NPI:1508305103
Name:NORTH END COMMUNITY HEALTH COMMITTEE INC
Entity Type:Organization
Organization Name:NORTH END COMMUNITY HEALTH COMMITTEE INC
Other - Org Name:NORTH END WATERFRONT HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEWH PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-724-9154
Mailing Address - Street 1:332 HANOVER STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113
Mailing Address - Country:US
Mailing Address - Phone:617-643-8085
Mailing Address - Fax:617-643-8711
Practice Address - Street 1:332 HANOVER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-1901
Practice Address - Country:US
Practice Address - Phone:617-643-8085
Practice Address - Fax:617-643-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MAMA00601833336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168140OtherPK