Organization
ANDERSON HOLDINGS
Active
Other names
J.E. PIERCE APOTHECARY COMPOUNDING LAB
Organization subpart
No
Provider details
NPI number
Authorized official
DERICK ANDERSON (PRESIDENT)
(617) 608-3022
Entity
Organization
Contact information
Practice address
1093 BEACON ST BSMT, BSMT, BROOKLINE, MA 02446-5649
(617) 608-3022
(617) 608-3023
Mailing address
1093 BEACON ST, BSMT, BROOKLINE, MA 02446-5695
(617) 608-3022
(617) 608-3023
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
89745
MA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2243361
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/07/2010
Last updated
12/07/2010
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