Healthcare Provider Details

I. General information

NPI: 1871847137
Provider Name (Legal Business Name): PHARMAHEALTH SPECIALTY/LONGTERM CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 AMORY ST
BOSTON MA
02119-1051
US

IV. Provider business mailing address

132 ALDEN RD
FAIRHAVEN MA
02719-4721
US

V. Phone/Fax

Practice location:
  • Phone: 877-737-0047
  • Fax: 508-998-1145
Mailing address:
  • Phone: 508-998-8000
  • Fax: 508-998-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateMA

VIII. Authorized Official

Name: PHILIP FALZARANO
Title or Position: PHARMACIST IN CHARGE
Credential: RPH.
Phone: 508-998-8000