# ATHOL FAMILY PHARMACY INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ATHOL FAMILY PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598858938
- **Authorized official:** HAMID MOHAGHEGH (PRESIDENT)
- **Authorized official phone:** (508) 755-4173

## Contact information

- **Practice address:** 321 MAIN ST, ATHOL, MA 01331-2233
- **Practice address phone:** (978) 249-9100
- **Practice address fax:** (978) 249-9199
- **Mailing address:** 100 GROVE ST, SUITE 201, WORCESTER, MA 01605-2627
- **Mailing address phone:** (508) 755-4173
- **Mailing address fax:** (508) 755-4173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | DS3480 | MA | Yes |

## Other

- **Enumeration date:** 09/30/2006
- **Last updated:** 12/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110074420/A | — | MA |
| 01 | — | 2039595 | PK | — |