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General NPI Number Information
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NPI Number | 1568657740
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Entity Type | Organization
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Legal Business Name | NORTHERN NEW ENGLAND COMPOUNDING PHARMACY
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 338 UNION ST
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City | LITTLETON
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State | NH
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Zip | 03561
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Country | US
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Telephone | 603-444-0094
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Fax |
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Provider Business Mailing Address
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Address Line | 338 UNION ST
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City | LITTLETON
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State | NH
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Zip | 03561
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Country | US
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Telephone | 603-444-0094
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID A ROCHEFORT
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Credential | R PH
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Telephone | 603-444-0094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail 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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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