# ROYAL PALM SPECIALTY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Royal Palm Specialty Pharmacy LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689965261
- **Authorized official:** AGNES RUBIN RPH (PRES)
- **Authorized official phone:** (508) 461-4045

## Contact information

- **Practice address:** 118 MAIN ST, WEBSTER, MA 01570-5205
- **Practice address phone:** (508) 461-4045
- **Practice address fax:** (508) 461-4044
- **Mailing address:** 118 MAIN ST, WEBSTER, MA 01570-5205
- **Mailing address phone:** (508) 461-4045
- **Mailing address fax:** (508) 461-4044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | DS89765 | MA | Yes |

## Other

- **Enumeration date:** 04/29/2011
- **Last updated:** 11/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2243537 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |