Organization
PRESCOTT PHARMACY LTC INC
Active
Other names
Prescott Pharmacy LTC, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TIMOTHY BUFFUM (PHARMACY MANAGER)
(508) 683-0260
Entity
Organization
Contact information
Practice address
100 GROVE ST STE B12, WORCESTER, MA 01605-2630
(508) 683-0260
(508) 683-0270
Mailing address
100 GROVE ST STE B12, WORCESTER, MA 01605-2630
(508) 683-0260
(508) 683-0270
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
DS90051
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162515
PK
—
Enumeration date
08/08/2016
Last updated
02/23/2024
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