MEDICARE: GREGORY FRANK SANGUEDOLCE B.S. PHARM

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	183500000X	Pharmacist	3227	NH
2	183500000X	Pharmacist	25051	MA

General Provider Information

NPI Number	:	1750382180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY FRANK SANGUEDOLCE B.S. PHARM

Provider Business Mailing Address
First Line	:	10 FASULO CT
Second Line	:
City	:	HAVERHILL
State	:	MA
Zip	:	01832-1976
Country	:	US
Telephone Number	:	978-697-3996
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 FASULO CT
Second Line	:
City	:	HAVERHILL
State	:	MA
Zip	:	01832-1976
Country	:	US
Telephone Number	:	978-697-3996
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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