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General NPI Number Information
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NPI Number | 1417397134
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL MEDICATION CONSULTANTS, LLC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 06/26/2013
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Provider Practice Location Address
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Address Line | 70 PICKENS ST
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City | LAKEVILLE
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State | MA
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Zip | 02347-1902
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Country | US
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Telephone | 774-213-5317
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Fax |
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Provider Business Mailing Address
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Address Line | 70 PICKENS ST
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City | LAKEVILLE
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State | MA
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Zip | 02347-1902
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Country | US
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Telephone | 774-213-5317
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ELIZABETH COUSINS SYLVIA
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Credential | RPH,MBA,CGP
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Telephone | 774-213-5317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 19301
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License Number State | MA
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