Healthcare Provider Details

I. General information

NPI: 1164349171
Provider Name (Legal Business Name): THERAGENIX PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MILL AND MAIN PL STE 500
MAYNARD MA
01754-2685
US

IV. Provider business mailing address

2 MILL AND MAIN PL STE 500
MAYNARD MA
01754-2685
US

V. Phone/Fax

Practice location:
  • Phone: 877-468-4979
  • Fax: 888-907-1156
Mailing address:
  • Phone: 877-468-4979
  • Fax: 888-907-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN J LEIGHTON
Title or Position: MANAGER OF RECORD
Credential: RPH
Phone: 617-962-1097