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General NPI Number Information
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NPI Number | 1093443475
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Entity Type | Individual
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Provider Name | CONNER THOMAS ROSE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 250 POND ST
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City | BRAINTREE
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State | MA
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Zip | 02184-5351
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Country | US
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Telephone | 781-348-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 200 QUARRY HILLS DR APT 2205
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City | QUINCY
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State | MA
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Zip | 02169-3859
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Country | US
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Telephone | 860-882-7221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH240988
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License Number State | MA
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