Healthcare Provider Details
I. General information
NPI: 1417232968
Provider Name (Legal Business Name): HRC CORP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 HUMBOLDT AVENUE
DORCHESTER MA
02120
US
IV. Provider business mailing address
201 HUMBOLDT AVENUE
DORCHESTER MA
02120
US
V. Phone/Fax
- Phone: 617-427-2222
- Fax: 617-427-2205
- Phone: 617-427-2222
- Fax: 617-427-2205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | DS89781 |
| License Number State | MA |
VIII. Authorized Official
Name: MR.
PAUL
GARBARINI
Title or Position: ATTORNEY
Credential:
Phone: 413-727-8191