Organization
CRAWFORD DRUG LLC
Active
Other names
Crawford Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES WILSON PHARM D (CO-OWNER)
(617) 436-3400
Entity
Organization
Contact information
Practice address
1735 DORCHESTER AVE, DORCHESTER, MA 02124-2535
(617) 436-3400
Mailing address
1735 DORCHESTER AVE, DORCHESTER, MA 02124-2535
(617) 436-3400
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110106701A
—
MA
Enumeration date
01/28/2020
Last updated
07/25/2024
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