Organization
APOTHECARE OF PLYMOUTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN NELSON RPH (PHARMACY MANAGER)
(508) 732-9700
Entity
Organization
Contact information
Practice address
121 CAMELOT DR STE 3, PLYMOUTH, MA 02360-3037
(508) 732-9700
(508) 732-9788
Mailing address
121 CAMELOT DR STE 3, PLYMOUTH, MA 02360-3037
(508) 732-9700
(508) 732-9788
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3481
MA
3336C0003X
Community/Retail Pharmacy
3481
MA
3336C0004X
Compounding Pharmacy
3481
MA
3336L0003X
Long Term Care Pharmacy
Primary
3481
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11074421A
—
MA
01
—
2241595
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
3481
STATE LICENSE
MA
Enumeration date
10/02/2006
Last updated
05/10/2012
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