Organization
DONG LAN CORPORATION
Active
Other names
Saigon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KIET THE NGO PHARMACIST (PRESIDENT OWNER MANAGER)
(617) 282-9134
Entity
Organization
Contact information
Practice address
1167 A DORCHESTER AVE, DORCHESTER, MA 02125
(617) 282-9134
(617) 282-9317
Mailing address
1167 A DORCHESTER AVE, DORCHESTER, MA 02125
(617) 282-9134
(617) 282-9317
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19274
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445738
—
MA
Enumeration date
02/12/2007
Last updated
08/22/2020
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