Organization
PLAZA PHARMACY OF WESTPORT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL WILLIAM VINCELETTE (PRESIDENT)
(508) 673-5364
Entity
Organization
Contact information
Practice address
655 STATE RD, WESTPORT, MA 02790-2848
(508) 673-5364
(508) 673-7074
Mailing address
655 STATE RD, WESTPORT, MA 02790-2848
(508) 673-5364
(508) 673-7074
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2222
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421251
—
MA
Enumeration date
08/29/2006
Last updated
08/22/2020
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