MEDICARE: DR. AARON J PROCTOR PHARM.D.

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	26912	MA
2	1835G0303X	Geriatric Pharmacist	26912	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26912	OTHER	MA	MA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1861685323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON J PROCTOR PHARM.D.

Provider Business Mailing Address
First Line	:	181 CEDAR HILL ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-3035
Country	:	US
Telephone Number	:	866-476-5224
Fax Number	:	866-476-5256

Provider Business Practice Location Address
First Line	:	181 CEDAR HILL ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-3035
Country	:	US
Telephone Number	:	866-476-5224
Fax Number	:	866-476-5256

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

Provider Enumeration Date	:	08/19/2007
Last Update Date	:	08/19/2007

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