Individual
OMAR AVILA VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
100 TECHNOLOGY CENTER DR, STOUGHTON, MA 02072-4710
(833) 976-1582
Mailing address
100 TECHNOLOGY CENTER DR, STOUGHTON, MA 02072-4710
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017509
OR
390200000X
Student in an Organized Health Care Education/Training Program
PI-0012356
OR
Other
Enumeration date
07/02/2019
Last updated
08/29/2023
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