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General NPI Number Information
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NPI Number | 1073900577
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Entity Type | Organization
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Legal Business Name | PHARMBLUE MASSACHUSETTS LLC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 163 PLEASANT ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-2457
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Country | US
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Telephone | 855-779-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 GRANITE PKWY STE 425
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City | PLANO
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State | TX
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Zip | 75024-6648
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Country | US
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Telephone | 469-592-2011
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Fax |
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Authorized Official
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Title or Position | VP LEGAL AFFAIRS
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Name | KRISTEN GURLEY
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Credential |
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Telephone | 469-592-2011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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