Organization
PELHAM COMMUNITY PHARMACY, INC
Active
Other names
PELHAM COMMUNITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BHUREN PATEL (OWNER)
(781) 966-2700
Entity
Organization
Contact information
Practice address
21 GREEN ST, WALTHAM, MA 02451-1646
(781) 966-2700
(781) 890-0234
Mailing address
21 GREEN ST, WALTHAM, MA 02451-1646
(781) 966-2700
(781) 890-0234
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
DS89647
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0407810
—
MA
01
—
2237837
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/19/2007
Last updated
11/22/2023
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