MEDICARE: DR. KEITH B THOMASSET PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	23725	MA

General Provider Information

NPI Number	:	1568468742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH B THOMASSET PHARM.D.

Provider Business Mailing Address
First Line	:	5 LINCOLN RD
Second Line	:
City	:	TEWKSBURY
State	:	MA
Zip	:	01876-3678
Country	:	US
Telephone Number	:	781-760-4849
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 MALL RD
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01805-2658
Country	:	US
Telephone Number	:	781-744-5077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	10/10/2022

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