Provider Demographics
NPI:1013220607
Name:CONLEYS DRUG STORE INC
Entity Type:Organization
Organization Name:CONLEYS DRUG STORE INC
Other - Org Name:CONLEYS DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-500-1530
Mailing Address - Street 1:20 DAMON AVE
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-3540
Practice Address - Country:US
Practice Address - Phone:978-283-3131
Practice Address - Fax:978-283-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADS897313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy