Provider Demographics
NPI:1114160694
Name:BAGARELLA, FRANCIS PETER (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:PETER
Last Name:BAGARELLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02556-2019
Mailing Address - Country:US
Mailing Address - Phone:508-564-4459
Mailing Address - Fax:508-564-6172
Practice Address - Street 1:111 COUNTY RD
Practice Address - Street 2:
Practice Address - City:NORTH FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02556-2019
Practice Address - Country:US
Practice Address - Phone:508-564-4459
Practice Address - Fax:508-564-6172
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA178272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17872OtherPHARMACY LICENSE