Organization
SHORX INC
Active
Other names
SHORE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DANA SHORE (OWNER)
(617) 484-7007
Entity
Organization
Contact information
Practice address
297 BELMONT ST, BELMONT, MA 02478-3410
(617) 484-7007
(617) 484-7099
Mailing address
297 BELMONT ST, BELMONT, MA 02478-3410
(617) 484-7007
(617) 484-7099
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1285
MA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432792
—
MA
01
—
2203139
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/21/2006
Last updated
06/03/2010
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