Provider Demographics
NPI:1477131282
Name:MACASKILL, KENNETH JR (RPH)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:MACASKILL
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 VAUGHN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-1050
Mailing Address - Country:US
Mailing Address - Phone:781-789-6240
Mailing Address - Fax:
Practice Address - Street 1:805 N WHITTINGTON PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-7101
Practice Address - Country:US
Practice Address - Phone:781-789-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist