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General NPI Number Information
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NPI Number | 1568653988
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Entity Type | Organization
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Legal Business Name | SMARTPAK EQUINE, LLC
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 40 GRISSOM ROAD SUITE 500
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City | PLYMOUTH
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State | MA
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Zip | 02360-7205
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Country | US
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Telephone | 800-431-4194
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Fax | 800-431-4179
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Provider Business Mailing Address
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Address Line | 40 GRISSOM RD SUITE 500
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City | PLYMOUTH
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State | MA
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Zip | 02360-7205
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Country | US
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Telephone | 800-431-4194
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Fax | 800-431-4179
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | THOMAS MCCAIN
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Credential |
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Telephone | 774-773-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | 3320
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License Number State | MA
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