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Organization
EDLINE GROUP INCORPORATED
Active
Organization
EDLINE GROUP INCORPORATED
Active
Other names
COMPTON DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD OBI (OWNER)
(617) 288-1616
Entity
Organization
Contact information
Practice address
393 COLUMBIA RD, DORCHESTER, MA 02125-2415
(617) 288-1616
(617) 506-6003
Mailing address
393 COLUMBIA RD, DORCHESTER, MA 02125-2415
(617) 288-1616
(617) 506-6003
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
3325
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406350
—
MA
01
—
2227812
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/20/2006
Last updated
12/16/2010
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