Healthcare Provider Details

I. General information

NPI: 1235357799
Provider Name (Legal Business Name): LOVELL THEODORE LANDON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 W MAIN ST
HILLSBORO NH
03244-5224
US

IV. Provider business mailing address

7 SPRAGUE RD
AMHERST NH
03031-3238
US

V. Phone/Fax

Practice location:
  • Phone: 603-464-4133
  • Fax: 603-464-6702
Mailing address:
  • Phone: 603-673-1097
  • Fax: 603-673-1097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2312
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: