Provider Demographics
NPI:1861726937
Name:ASTRAZENECA LP
Entity type:Organization
Organization Name:ASTRAZENECA LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SITE GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNESSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-839-4504
Mailing Address - Street 1:35 GATEHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1215
Mailing Address - Country:US
Mailing Address - Phone:781-839-4000
Mailing Address - Fax:
Practice Address - Street 1:35 GATEHOUSE DR
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1215
Practice Address - Country:US
Practice Address - Phone:781-839-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASTRAZENECA LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine