Cambridge Public Health Commission
Organization Active NPI Community/Retail Pharmacy · Revere, MA
NPI 1134812647 · NPPES record last updated Jun 2, 2023
Key facts
- NPI
- 1134812647
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- CAMBRIDGE PUBLIC HEALTH COMMISSION
- Practice address
- 454 Broadway
Revere, MA 02151-3034 - Phone
- (781) 485-8272
- NPI assigned
- May 31, 2023
- Organization subpart
- No
Authorized official
- Name
- Maria Kossilos
- Title
- Associate Chief Pharmacy Officer
- Phone
- (617) 806-8505
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 43
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200914000845 | MA | Part B Supplier - Pharmacy | 8921910894 |
5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Revere, MA; Cambridge, MA; Medford, MA; Malden, MA |
National Provider Directory
- Tax ID family
- Cambridge Public Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
454 Broadway
Revere, MA 02151-3034
Mailing address
454 Broadway
Revere, MA 02151-3034
Phone (781) 485-8272
Other names
- Cambridge Health Alliance Outpatient Pharmacy Revere
Other providers in Revere, MA
- Alannah Rose Burke
- Jessica E Burke
- Susan Curley Burton
- Melissa Bustamante
- Thomas Byrne
- Debbie Ann Campbell
- Melissa Canavan
- John William Cann
- Vitor Cardoso
- Caresafe Services LLC
All providers in Revere, MA · Community/Retail Pharmacy in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.