# PROCARE LTC OF MA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PROCARE LTC OF MA, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932556438
- **Authorized official:** DR. BINCY VARGHESE PHARM D (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (888) 741-0367

## Contact information

- **Practice address:** 155 NORTHBORO RD STE 4, SOUTHBOROUGH, MA 01772-1033
- **Practice address phone:** (508) 481-5800
- **Practice address fax:** (508) 481-5801
- **Mailing address:** 1 OLYMPIC PL STE 600, TOWSON, MD 21204-4110
- **Mailing address phone:** (888) 741-0367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | DS90042 | MA | Yes |

## Other

- **Enumeration date:** 05/16/2016
- **Last updated:** 06/07/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110115534A | — | MA |
| 01 | — | 2160164 | PK | — |