Healthcare Provider Details
I. General information
NPI: 1326122466
Provider Name (Legal Business Name): ANDERSON PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2006
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
52 BRIDGE ST
SHELBURNE FALLS MA
01370-1131
US
IV. Provider business mailing address
PO BOX 188
SHELBURNE FALLS MA
01370-0188
US
V. Phone/Fax
- Phone: 413-625-6324
- Fax: 413-625-9018
- Phone: 413-625-6324
- Fax: 413-625-9018
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 12518 |
| License Number State | MA |
VIII. Authorized Official
Name:
ZACHARY
ELIAS
BARRIEAU
Title or Position: MANAGER
Credential:
Phone: 413-261-6664