Healthcare Provider Details

I. General information

NPI: 1396246179
Provider Name (Legal Business Name): CHRISTOPHER KOWALSKI B.S. PHARM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 BOSTON RD
CHELMSFORD MA
01824-3013
US

IV. Provider business mailing address

18 CARTER DR
CHELMSFORD MA
01824-2808
US

V. Phone/Fax

Practice location:
  • Phone: 978-256-2577
  • Fax:
Mailing address:
  • Phone: 978-250-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16732
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: