Individual
RAUL ASASOUK SANTIAGO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCPS, BCIDP
Contact information
Practice address
1153 CENTRE ST, PHARMACY, BOSTON, MA 02130-3446
(617) 983-7247
Mailing address
1153 CENTRE ST, PHARMACY, BOSTON, MA 02130-3446
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH234641
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MCS000091P
MASSACHUSETTS CONTROLLED SUBSTANCES REGISTRATION
MA
Enumeration date
05/27/2014
Last updated
12/03/2021
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