Organization
ELMWOOD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD HEITIN PHARMACIST (OWNER/PRESIDENT)
(781) 322-2117
Entity
Organization
Contact information
Practice address
299 PLEASANT ST, MALDEN, MA 02148-8105
(781) 322-2117
Mailing address
299 PLEASANT ST, MALDEN, MA 02148-8105
(781) 322-2117
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9460
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404799
—
MA
Enumeration date
08/12/2006
Last updated
08/22/2020
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