Healthcare Provider Details

I. General information

NPI: 1720195332
Provider Name (Legal Business Name): ROWLEY PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 MAIN ST
ROWLEY MA
01969
US

IV. Provider business mailing address

169 MAIN ST
ROWLEY MA
01969
US

V. Phone/Fax

Practice location:
  • Phone: 978-948-2208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2199
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2199
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0412953
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name: WILLIAM MACDONALD
Title or Position: PRESIDENT
Credential:
Phone: 978-948-2208