Organization
BELMONT PHARMACY LLC
Active
Other names
Belmont Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PAVLAN (OWNER / PIC)
(617) 489-1616
Entity
Organization
Contact information
Practice address
246 TRAPELO RD, BELMONT, MA 02478-1849
(617) 489-1616
(617) 489-1066
Mailing address
246 TRAPELO RD, BELMONT, MA 02478-1849
(617) 489-1616
(617) 489-1066
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
DS89932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110102210A
—
MA
01
—
2141095
PK
—
Enumeration date
06/20/2013
Last updated
05/04/2015
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