Organization
DUVALS PHARMACY STORE 2 INC
Active
Other names
DUVALS PHARNACY
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON BURTT RPH (MANG)
(508) 350-2900
Entity
Organization
Contact information
Practice address
1 COMPASS WAY, STE 101, EAST BRIDGEWATER, MA 02333-1465
(508) 350-2900
Mailing address
PO BOX 429, WHITMAN, MA 02382-0429
(781) 447-0608
(781) 447-0876
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
DS3554
MA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2242117
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/19/2007
Last updated
03/25/2010
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