Provider Demographics
NPI:1285851881
Name:BOSHAR, PHILIP M
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:M
Last Name:BOSHAR
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 1:23 SIROD RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1401
Mailing Address - Country:US
Mailing Address - Phone:603-434-5414
Mailing Address - Fax:
Practice Address - Street 1:288 SANDOWN RD
Practice Address - Street 2:
Practice Address - City:E HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03826-2409
Practice Address - Country:US
Practice Address - Phone:603-329-9521
Practice Address - Fax:603-329-9527
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist