Healthcare Provider Details

I. General information

NPI: 1700931532
Provider Name (Legal Business Name): D & M POWERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1868 CENTRE ST
WEST ROXBURY MA
02132-1902
US

IV. Provider business mailing address

1868 CENTRE ST
WEST ROXBURY MA
02132-1902
US

V. Phone/Fax

Practice location:
  • Phone: 617-325-0017
  • Fax: 617-327-7611
Mailing address:
  • Phone: 617-325-0017
  • Fax: 617-327-7611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2845
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number2845
License Number StateMA

VIII. Authorized Official

Name: MR. MICHAEL WILLIAM WESSENBERG
Title or Position: OWNER
Credential: RPH
Phone: 617-325-0017