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General NPI Number Information
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NPI Number | 1558479741
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Entity Type | Organization
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Legal Business Name | CIN-DON
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 57 MARKET ST
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City | LYNN
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State | MA
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Zip | 01901-1004
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Country | US
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Telephone | 781-592-0282
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Fax | 781-593-2954
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Provider Business Mailing Address
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Address Line | 103 QUINN RD
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City | LYNN
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State | MA
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Zip | 01904-1259
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Country | US
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Telephone | 781-592-0282
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Fax | 781-593-2954
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Authorized Official
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Title or Position | OWNER
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Name | MR. DONALD F GOODWIN JR.
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Credential |
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Telephone | 781-592-0282
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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 | 2516
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License Number State | MA
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