MEDICARE: FALMOUTH PHARMA LLC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy
3	3336L0003X	Long Term Care Pharmacy	DS89895	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2143912	OTHER		PK

General Provider Information

NPI Number	:	1760488340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALMOUTH PHARMA LLC

Provider Business Mailing Address
First Line	:	111 COUNTY RD
Second Line	:
City	:	N FALMOUTH
State	:	MA
Zip	:	02556-2019
Country	:	US
Telephone Number	:	508-564-4459
Fax Number	:	508-564-6172

Provider Business Practice Location Address
First Line	:	111 COUNTY RD
Second Line	:
City	:	N FALMOUTH
State	:	MA
Zip	:	02556-2019
Country	:	US
Telephone Number	:	508-564-4459
Fax Number	:	508-564-6172

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	SNEHA KRISHNAKUMAR
Credential	:
Telephone Number	:	508-564-4459

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	06/07/2023

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Directions to “FALMOUTH PHARMA LLC ” Practice Location

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