Organization
SHORE PHARMACY
Active
Organization
SHORE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PASQUARIELLO (OWNER)
(781) 395-4420
Entity
Organization
Contact information
Practice address
429 HIGH ST, MEDFORD, MA 02155-3632
(781) 395-4420
(781) 379-2962
Mailing address
429 HIGH ST, MEDFORD, MA 02155-3632
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2621
MA
333600000X
Pharmacy
2621
MA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0426644
—
MA
01
—
2200917
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/12/2006
Last updated
09/11/2025
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