Provider Demographics
NPI:1437402864
Name:WINCHESTER PHARMACY INC.
Entity Type:Organization
Organization Name:WINCHESTER PHARMACY INC.
Other - Org Name:WINCHESTER PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DINNO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:978-369-3100
Mailing Address - Street 1:568 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1953
Mailing Address - Country:US
Mailing Address - Phone:781-570-2320
Mailing Address - Fax:781-570-2327
Practice Address - Street 1:568 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1953
Practice Address - Country:US
Practice Address - Phone:781-570-2320
Practice Address - Fax:781-570-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MADS898483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110094912AMedicaid
MADS90427OtherPHARMACY LICENSE
2243979OtherNCPDP