# ATHOL PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Athol Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407398589
- **Authorized official:** STEVEN MACNEILL RPH (PRESIDENT)
- **Authorized official phone:** (978) 830-0427

## Contact information

- **Practice address:** 290 MAIN ST, ATHOL, MA 01331-2226
- **Practice address phone:** (978) 830-0427
- **Practice address fax:** (978) 830-0430
- **Mailing address:** 290 MAIN ST, ATHOL, MA 01331-2226
- **Mailing address phone:** (978) 830-0427
- **Mailing address fax:** (978) 830-0430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | DS90085 | MA | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2016
- **Last updated:** 05/31/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2166237 | PK | — |