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General NPI Number Information
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NPI Number | 1184631749
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Entity Type | Organization
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Legal Business Name | VILLAGE PHARMACY OF MARBLEHEAD INC.
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 1 VILLAGE PLZ
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City | MARBLEHEAD
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State | MA
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Zip | 01945-2373
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Country | US
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Telephone | 781-631-8100
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Fax | 781-639-2919
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Provider Business Mailing Address
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Address Line | 1 VILLAGE PLZ
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City | MARBLEHEAD
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State | MA
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Zip | 01945-2373
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Country | US
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Telephone | 781-631-8100
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Fax | 781-639-2919
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Authorized Official
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Title or Position | OWNER AND PRESIDENT
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Name | ELLIOT STRASNICK
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Credential |
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Telephone | 781-631-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9701
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License Number State | MA
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