Organization
PAWTUCKET PHARMACY INC
Active
Other names
PAWTUCKET PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
BOB AUDET (OWNER)
(978) 458-3366
Entity
Organization
Contact information
Practice address
65 SCHOOL ST, LOWELL, MA 01854-3239
(978) 458-3366
(978) 454-5051
Mailing address
65 SCHOOL ST, LOWELL, MA 01854-3239
(978) 458-3366
(978) 454-5051
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
789
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0417793
—
MA
01
—
2200789
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
06/03/2010
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