Healthcare Provider Details

I. General information

NPI: 1942960174
Provider Name (Legal Business Name): ADRIANA MARGARET MOLLO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 12/29/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CABOT ST
BEVERLY MA
01915-5048
US

IV. Provider business mailing address

25 CABOT ST
BEVERLY MA
01915-5048
US

V. Phone/Fax

Practice location:
  • Phone: 978-524-4800
  • Fax: 978-524-4809
Mailing address:
  • Phone: 978-524-4800
  • Fax: 978-524-4809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number232742
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: