Individual
DERICK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1180 BEACON ST, BROOKLINE, MA 02446-3885
(617) 566-4080
(617) 566-2757
Mailing address
50 STARK RD, DERRY, NH 03038-4611
(617) 566-4080
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25168
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25168
MASSACHUSETTS BOARD OF PHARMACY
MA
01
—
R1998
NEW HAMPSHIRE BOARD OF PHARMACY
NH
Enumeration date
11/01/2006
Last updated
08/14/2012
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