| NPI | 1487759577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D FENSKY Director Of Operations 617-327-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MA 3335) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 3335) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MA 3335) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MA 3335) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: MA 3335) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MA DS3335) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-05-21 |