Provider Demographics
NPI:1164028023
Name:EASTWOOD, DAVID ARTHUR
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ARTHUR
Last Name:EASTWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2221
Mailing Address - Country:US
Mailing Address - Phone:781-467-8752
Mailing Address - Fax:
Practice Address - Street 1:155 CENTER ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-2221
Practice Address - Country:US
Practice Address - Phone:781-467-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist