Provider Demographics
NPI:1235355561
Name:PENNEY, EVERETT FRANCIS JR
Entity Type:Individual
Prefix:MR
First Name:EVERETT
Middle Name:FRANCIS
Last Name:PENNEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:EVERETT
Other - Middle Name:
Other - Last Name:PENNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:56 DOYLE AVE
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3526
Mailing Address - Country:US
Mailing Address - Phone:978-957-2794
Mailing Address - Fax:
Practice Address - Street 1:172 KINSLEY ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3648
Practice Address - Country:US
Practice Address - Phone:603-835-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14652183500000X
NH1696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist