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Organization
PRESCOTT PHARMACY LTC INC
Active
Organization
PRESCOTT PHARMACY LTC INC
Active
Other names
Prescott Pharmacy LTC, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TIMOTHY BUFFUM (PHARMACY MANAGER)
(508) 683-0260
Entity
Organization
Contact information
Practice address
100 GROVE ST STE B12, WORCESTER, MA 01605-2630
(508) 683-0260
(508) 683-0270
Mailing address
100 GROVE ST STE B12, WORCESTER, MA 01605-2630
(508) 683-0260
(508) 683-0270
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
DS90051
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162515
PK
—
Enumeration date
08/08/2016
Last updated
02/23/2024
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