Healthcare Provider Details

I. General information

NPI: 1154863835
Provider Name (Legal Business Name): HEALTH CARE FAMILY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 LOON HILL RD
DRACUT MA
01826-4015
US

IV. Provider business mailing address

14 LOON HILL RD
DRACUT MA
01826-4015
US

V. Phone/Fax

Practice location:
  • Phone: 978-455-0570
  • Fax: 978-455-6921
Mailing address:
  • Phone: 978-455-0570
  • Fax: 978-455-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberDS90065
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SOTHEARA OUK
Title or Position: MANAGER
Credential: RPH
Phone: 978-455-0570