Individual
DR. RICKY BALUBHAI THUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 822-8374
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 822-8374
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH234175
MA
1835P2201X
Ambulatory Care Pharmacist
Primary
PH234175
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MCS000011P
CONTROLLED SUBSTANCE REGISTRATION (MASSACHUSETTS)
MA
01
—
PH234175
PHARMACIST STATE LICENSE (MASSACHUSETTS)
MA
Enumeration date
08/13/2014
Last updated
06/11/2019
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