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Organization
NORTHEAST PHARMACY SERVICES LLC
Active
Organization
NORTHEAST PHARMACY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES JOHN FANARAS RPH (CEO)
(603) 223-3111
Entity
Organization
Contact information
Practice address
1 GRANITE PL, SUITE 200 NORTH, CONCORD, NH 03301-3258
(603) 224-9591
(603) 225-6579
Mailing address
1 GRANITE PL, SUITE 200 NORTH, CONCORD, NH 03301-3258
(603) 224-9591
(603) 225-6579
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
0655
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0655P
NEW HAMPSHIRE BOARD OF PHARMACY
NH
01
—
3007095
NABP
NH
05
—
3077603
—
NH
Enumeration date
09/26/2006
Last updated
12/29/2020
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