Provider Demographics
NPI:1326122466
Name:ANDERSON PHARMACY INC
Entity Type:Organization
Organization Name:ANDERSON PHARMACY INC
Other - Org Name:BAKER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-625-6324
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-0188
Mailing Address - Country:US
Mailing Address - Phone:413-625-6324
Mailing Address - Fax:413-625-9018
Practice Address - Street 1:52 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370-1131
Practice Address - Country:US
Practice Address - Phone:413-625-6324
Practice Address - Fax:413-625-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MA125183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0400823Medicaid
2039440OtherPK