Healthcare Provider Details

I. General information

NPI: 1699056820
Provider Name (Legal Business Name): TOMS NEW PLACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 QUARRY ST
FALL RIVER MA
02723-1025
US

IV. Provider business mailing address

387 QUARRY ST SUITE 103
FALL RIVER MA
02723-1025
US

V. Phone/Fax

Practice location:
  • Phone: 774-322-1335
  • Fax: 508-617-4546
Mailing address:
  • Phone: 774-322-1335
  • Fax: 508-617-4546

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 NumberDS89814
License Number StateMA

VIII. Authorized Official

Name: THOMAS CORY
Title or Position: PHARMACY OWNER
Credential: PHARM D
Phone: 508-264-9303