| NPI | 1487747655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN NELSON Pharmacy Manager 508-732-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MA 3481) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 3481) |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MA 3481) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MA 3481) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-05-10 |