Organization
LIBUN APOTHECARY & SURGICAL SUPPLY, INC
Active
Other names
BAXTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS R LIBBY RPH (PRESIDENT)
(617) 773-7733
Entity
Organization
Contact information
Practice address
464 WASHINGTON ST, QUINCY, MA 02169-5716
(617) 773-7733
(617) 773-8372
Mailing address
464 WASHINGTON ST, QUINCY, MA 02169-5716
(617) 773-7733
(617) 773-8372
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3502
MA
3336C0003X
Community/Retail Pharmacy
Primary
3502
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408247
—
MA
01
—
2225921
NABP
MA
01
—
3502
LICENSE
MA
Enumeration date
09/26/2006
Last updated
03/02/2016
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