Provider Demographics
NPI:1104035195
Name:BROOKS-ECKERD PHARMACY
Entity Type:Organization
Organization Name:BROOKS-ECKERD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:SILBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-772-0749
Mailing Address - Street 1:295 SALEM ST
Mailing Address - Street 2:UNIT 9
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2064
Mailing Address - Country:US
Mailing Address - Phone:781-933-2786
Mailing Address - Fax:
Practice Address - Street 1:28 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2550
Practice Address - Country:US
Practice Address - Phone:603-772-0749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1678261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health