NPIMap

Organization Active NPI

Charles River Community Health Center

Doing business as Charles River Community Health

  • Community/Retail Pharmacy
  • Waltham, MA
National Provider Identifier
1639445034
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
DS90057 Issued in MA
Legal business name
CHARLES RIVER COMMUNITY HEALTH CENTER
Doing business as
Charles River Community Health
Practice address
43 Foundry Ave Ste 110
Waltham, MA 02453-8313
Phone
(781) 693-3873
Fax
(781) 693-3810
NPI assigned
Mar 29, 2012
Last updated
Apr 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Lockwood Mullaney
Title
Ceo
Phone
(617) 783-0500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X DS90057 MA Primary

Addresses

Primary practice location

43 Foundry Ave Ste 110
Waltham, MA 02453-8313

Mailing address

43 Foundry Ave
Waltham, MA 02453-8313
Phone (781) 693-3873

Other identifiers 2

IdentifierTypeStateIssuer
2134273OtherPK
10024306SMedicaidMA

Other names 1

  • Charles River Community Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
JM Smith Community Heal7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

43 Foundry Ave
Ste 110
Waltham, MA 02453
Phone (781) 693-3800

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1639445034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 FOUNDRY AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024538313",
            "telephone_number": "781-693-3873",
            "fax_number": "781-693-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 FOUNDRY AVE STE 110",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024538313",
            "telephone_number": "781-693-3873",
            "fax_number": "781-693-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES RIVER COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "LOCKWOOD MULLANEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-783-0500"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "DS90057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134273",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024306S",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles River Community Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.