Provider Demographics
NPI:1508897695
Name:PARTNERS OF MASSACHUSETTS, LLC
Entity Type:Organization
Organization Name:PARTNERS OF MASSACHUSETTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-206-2664
Mailing Address - Street 1:181 CEDAR HILL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3035
Mailing Address - Country:US
Mailing Address - Phone:508-624-8880
Mailing Address - Fax:508-624-8890
Practice Address - Street 1:181 CEDAR HILL ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3035
Practice Address - Country:US
Practice Address - Phone:508-624-8880
Practice Address - Fax:508-624-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34193336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2241153OtherNCPDP NUMBER
NV100508310Medicaid
MA0407470Medicaid
MA3419OtherMA PHARMACY LICENSE
VA010259819Medicaid
NV100508310Medicaid
5723310001Medicare NSC