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General NPI Number Information
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NPI Number | 1831194083
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Entity Type | Organization
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Legal Business Name | FARLEYS REXALL PHARMACY INC
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 103 BOULDER POINT DR.
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City | PLYMOUTH
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State | NH
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Zip | 03264-1130
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Country | US
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Telephone | 603-536-1086
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Fax | 603-536-5143
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Provider Business Mailing Address
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Address Line | PO BOX 27
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City | PLYMOUTH
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State | NH
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Zip | 03264-0027
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Country | US
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Telephone | 603-536-1086
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Fax | 603-536-5143
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RALPH L OLIVER
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Credential | R.PH.
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Telephone | 603-536-1086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0152P
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License Number State | NH
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