Healthcare Provider Details

I. General information

NPI: 1356635536
Provider Name (Legal Business Name): CARL F DIFRANCO SR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2011
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N STATE ST
CONCORD NH
03301-5015
US

IV. Provider business mailing address

14 GERTRUDE RD
WINDHAM NH
03087-1136
US

V. Phone/Fax

Practice location:
  • Phone: 603-223-6713
  • Fax: 603-225-8017
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR1417
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH18172
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR5017
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: