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General NPI Number Information
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NPI Number | 1912702010
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Entity Type | Individual
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Provider Name | KEVIN MICHAEL CONNELL PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 85 HERRICK ST
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City | BEVERLY
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State | MA
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Zip | 01915-1777
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Country | US
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Telephone | 978-922-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 20 BELMONT ST
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City | BEVERLY
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State | MA
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Zip | 01915-2429
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Country | US
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Telephone | 774-219-4120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PR46828
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH238831
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License Number State | MA
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