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General NPI Number Information
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NPI Number | 1396469631
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Entity Type | Individual
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Provider Name | JENNIFER FORSBLOM
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Gender | Female
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 786 ASHLEY BLVD
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City | NEW BEDFORD
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State | MA
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Zip | 02745-5548
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Country | US
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Telephone | 508-998-3831
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Fax |
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Provider Business Mailing Address
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Address Line | 18 DAVIS FARM LN
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City | ACUSHNET
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State | MA
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Zip | 02743-1019
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Country | US
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Telephone |
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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 | PH26344
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License Number State | MA
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