Organization
SULLIVAN'S PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ROGERS RPH (MANAGER)
(617) 323-6544
Entity
Organization
Contact information
Practice address
1 CORINTH ST, ROSLINDALE, MA 02131-3014
(617) 323-6544
(617) 469-5627
Mailing address
1 CORINTH ST, ROSLINDALE, MA 02131-3014
(617) 323-6544
(617) 469-5627
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1243
MA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0413127
—
MA
01
—
2217746
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/13/2006
Last updated
12/08/2025
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