Organization
ATHOL FAMILY PHARMACY INCORPORATED
Active
Other names
ATHOL FAMILY PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
HAMID MOHAGHEGH (PRESIDENT)
(508) 755-4173
Entity
Organization
Contact information
Practice address
321 MAIN ST, ATHOL, MA 01331-2233
(978) 249-9100
(978) 249-9199
Mailing address
100 GROVE ST, SUITE 201, WORCESTER, MA 01605-2627
(508) 755-4173
(508) 755-4173
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
DS3480
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074420/A
—
MA
01
—
2039595
PK
—
Enumeration date
09/30/2006
Last updated
12/02/2015
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