MEDICARE: MRS. EVANGELINE PAPPAS RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	17088	MA

General Provider Information

NPI Number	:	1740595388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EVANGELINE PAPPAS RPH

Provider Business Mailing Address
First Line	:	638 WASHINGTON ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-4212
Country	:	US
Telephone Number	:	781-341-0938
Fax Number	:	781-341-2758

Provider Business Practice Location Address
First Line	:	638 WASHINGTON ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-4212
Country	:	US
Telephone Number	:	781-341-0938
Fax Number	:	781-341-2758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2010
Last Update Date	:	08/06/2010

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