Organization
BALBONIS DRUG STORE INC
Active
Other names
BALBONIS DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD TASSINARI (CHIEF PHRM)
(508) 746-1251
Entity
Organization
Contact information
Practice address
289 COURT ST, PLYMOUTH, MA 02360-4380
(508) 746-1251
(508) 747-1549
Mailing address
289 COURT ST, PLYMOUTH, MA 02360-4380
(508) 746-1251
(508) 747-1549
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1287
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0499781
—
MA
01
—
2039420
PK
—
Enumeration date
10/02/2006
Last updated
02/14/2017
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