Healthcare Provider Details

I. General information

NPI: 1164594636
Provider Name (Legal Business Name): DANS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BAYBERRY CT
NANTUCKET MA
02554-4057
US

IV. Provider business mailing address

5 BAYBERRY CT
NANTUCKET MA
02554-4057
US

V. Phone/Fax

Practice location:
  • Phone: 508-825-9100
  • Fax: 508-825-2154
Mailing address:
  • Phone: 508-825-9100
  • Fax: 508-825-2154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2937
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number2037
License Number StateMA

VIII. Authorized Official

Name: DANIEL B BALLING
Title or Position: PRESIDENT
Credential: RPH
Phone: 508-825-9100