MEDICARE: ASHLEY MARIE GAUTHIER 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	PH234665	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851868962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MARIE GAUTHIER RPH

Provider Business Mailing Address
First Line	:	515 LINCOLN ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-2092
Country	:	US
Telephone Number	:	508-485-0432
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 LINCOLN ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-2088
Country	:	US
Telephone Number	:	508-485-0432
Fax Number	:

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

Provider Enumeration Date	:	10/26/2018
Last Update Date	:	10/26/2018

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