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Organization
PROCARE LTC OF MA LLC
Active
Organization
PROCARE LTC OF MA LLC
Active
Other names
PROCARE LTC OF MA, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BINCY VARGHESE PHARM D (DIRECTOR OF COMPLIANCE)
(888) 741-0367
Entity
Organization
Contact information
Practice address
155 NORTHBORO RD STE 4, SOUTHBOROUGH, MA 01772-1033
(508) 481-5800
(508) 481-5801
Mailing address
1 OLYMPIC PL STE 600, TOWSON, MD 21204-4110
(888) 741-0367
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
DS90042
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110115534A
—
MA
01
—
2160164
PK
—
Enumeration date
05/16/2016
Last updated
06/07/2024
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