Healthcare Provider Details

I. General information

NPI: 1265364780
Provider Name (Legal Business Name): MICHAEL JOSEPH DESMARAIS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 STATE ST
SPRINGFIELD MA
01109-4104
US

IV. Provider business mailing address

52 BAYBERRY LN
WEST SPRINGFIELD MA
01089-4547
US

V. Phone/Fax

Practice location:
  • Phone: 413-736-0351
  • Fax: 413-734-7037
Mailing address:
  • Phone: 413-736-0351
  • Fax: 413-734-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: