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General NPI Number Information
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NPI Number | 1710226923
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Entity Type | Organization
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Legal Business Name | GOOD HEALTH PHARM INC.
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Dates
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Enumeration Date | 02/07/2013
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 1690 COMMONWEALTH AVE
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City | BRIGHTON
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State | MA
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Zip | 02135-5602
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Country | US
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Telephone | 617-322-0077
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Fax |
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Provider Business Mailing Address
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Address Line | 1690 COMMONWEALTH AVE
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City | BRIGHTON
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State | MA
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Zip | 02135-5602
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Country | US
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Telephone | 617-322-0077
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IGOR KUZMIN
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Credential | PHARMD
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Telephone | 617-322-0077
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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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