Healthcare Provider Details

I. General information

NPI: 1750298576
Provider Name (Legal Business Name): EAST WEST PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 BROADWAY
SOMERVILLE MA
02144-1702
US

IV. Provider business mailing address

1210 BROADWAY
SOMERVILLE MA
02144-1702
US

V. Phone/Fax

Practice location:
  • Phone: 781-712-9500
  • Fax: 781-876-0027
Mailing address:
  • Phone: 781-712-9500
  • Fax: 781-876-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. THUAN NGUYEN
Title or Position: OWNER
Credential:
Phone: 781-712-9500