Provider Demographics
NPI:1356973887
Name:DANA-FARBER CANCER INSTITUTE, INC.
Entity type:Organization
Organization Name:DANA-FARBER CANCER INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIALTY PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:POQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:508-277-3377
Mailing Address - Street 1:5 BRANCH STREET
Mailing Address - Street 2:FLOOR 1, ROOM 1040
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-1964
Mailing Address - Country:US
Mailing Address - Phone:978-620-2075
Mailing Address - Fax:617-751-7030
Practice Address - Street 1:5 BRANCH STREET
Practice Address - Street 2:FLOOR 1, ROOM 1040
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-1964
Practice Address - Country:US
Practice Address - Phone:978-620-2075
Practice Address - Fax:617-751-7030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANA-FARBER CANCER INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-12
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy