Provider Demographics
NPI:1235292863
Name:PPF INC
Entity Type:Organization
Organization Name:PPF INC
Other - Org Name:RICHMOND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASSICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-592-4172
Mailing Address - Street 1:499 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-1570
Mailing Address - Country:US
Mailing Address - Phone:781-592-4172
Mailing Address - Fax:781-595-9845
Practice Address - Street 1:499 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-1570
Practice Address - Country:US
Practice Address - Phone:781-592-4172
Practice Address - Fax:781-595-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336L0003X
MADS16503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0436054Medicaid
2036132OtherPK