Organization
PEARL STREET PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROCKY TENGALIA RPH (PRESIDENT)
(781) 925-2378
Entity
Organization
Contact information
Practice address
1 PEARL ST, BROCKTON, MA 02301-2864
(508) 588-7455
(508) 588-7400
Mailing address
1 PEARL ST, BROCKTON, MA 02301-2864
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
DS3565
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2242155
OTHER ID NUMBER
—
Enumeration date
12/05/2007
Last updated
01/03/2008
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