Healthcare Provider Details

I. General information

NPI: 1205989506
Provider Name (Legal Business Name): SERIO BROTHERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 MAIN ST
WESTMINSTER MA
01473-1542
US

IV. Provider business mailing address

PO BOX 890
WESTMINSTER MA
01473-1542
US

V. Phone/Fax

Practice location:
  • Phone: 978-874-5812
  • Fax: 978-874-1817
Mailing address:
  • Phone: 978-874-5812
  • Fax: 978-874-1817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1710
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number1710
License Number StateMA

VIII. Authorized Official

Name: MR. DAVID BECK
Title or Position: OWNER/PRESIDENT
Credential: RPH
Phone: 987-874-5812