Healthcare Provider Details

I. General information

NPI: 1508159716
Provider Name (Legal Business Name): PHARMAHEALTH SPECIALTY/LONG TERM CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 05/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 ALDEN ROAD
FAIRHAVEN MA
02719-4721
US

IV. Provider business mailing address

132 ALDEN ROAD
FAIRHAVEN MA
02719-4721
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILIP FALZARANO
Title or Position: CHIEF OPERATING OFFICER
Credential: R PH
Phone: 508-998-8000