# BELMONT PHARMACY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1609215946
- **Authorized official:** ROBERT PAVLAN (OWNER / PIC)
- **Authorized official phone:** (617) 489-1616

## Contact information

- **Practice address:** 246 TRAPELO RD, BELMONT, MA 02478-1849
- **Practice address phone:** (617) 489-1616
- **Practice address fax:** (617) 489-1066
- **Mailing address:** 246 TRAPELO RD, BELMONT, MA 02478-1849
- **Mailing address phone:** (617) 489-1616
- **Mailing address fax:** (617) 489-1066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | DS89932 | MA | Yes |

## Other

- **Enumeration date:** 06/20/2013
- **Last updated:** 05/04/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110102210A | — | MA |
| 01 | — | 2141095 | PK | — |