| NPI | 1851463640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD DAVID Owner 508-747-1247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MA DS2640) |
| Additional Taxonomies | 3336M0003X Pharmacy Managed Care Organization Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2012-04-23 |