Healthcare Provider Details

I. General information

NPI: 1033039227
Provider Name (Legal Business Name): MICHAEL DESMOND PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 DEDHAM ST STE 300
CANTON MA
02021-1420
US

IV. Provider business mailing address

780 DEDHAM ST STE 300
CANTON MA
02021-1420
US

V. Phone/Fax

Practice location:
  • Phone: 781-232-5400
  • Fax:
Mailing address:
  • Phone: 781-232-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License NumberPH237592
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: