Healthcare Provider Details

I. General information

NPI: 1275947582
Provider Name (Legal Business Name): SANDY MARIE KUKLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 PLEASANT ST
FALL RIVER MA
02723-1000
US

IV. Provider business mailing address

933 PLEASANT ST
FALL RIVER MA
02723-1000
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-9600
  • Fax:
Mailing address:
  • Phone: 508-679-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH234274
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: