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Organization

SOUTHCOAST HOSPITALS GROUP INC

Active
Other names
Southcoast Specialty Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
WADE DUDLEY BROUGHMAN (EVP - CHIEF FINANCIAL OFFICER)
(508) 973-2908
Entity
Organization

Contact information

Practice address
206 MILL RD, SOUTHCOAST SPECIALTY PHARMACY, FAIRHAVEN, MA 02719
(508) 973-3320
Mailing address
101 PAGE ST, SOUTHCOAST PHARMACY, NEW BEDFORD, MA 02740-3464
(508) 973-5760

Taxonomy

Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DS89929
STATE BOARD OF PHARMACY LICENSE NUMBER
MA
Enumeration date
02/02/2023
Last updated
02/02/2023
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