| Organization Name: | EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC |
| NPI Number: | 1013048347 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTONIA G MCGUIRE (PRESIDENT & CEO) |
| Mailing Address: | 19 Tacoma St Worcester |
| State: | MA US |
| Postal Code: | 016053516 |
| Phone Number: | 5088542128 |
| Fax Number: | 5085951127 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 02/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | 495 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |