Provider Demographics
NPI:1568580009
Name:WEST, DENISE A (RPH, CDM)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:A
Last Name:WEST
Suffix:
Gender:F
Credentials:RPH, CDM
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:FALK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:190 SAWYERS LN
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-6298
Mailing Address - Country:US
Mailing Address - Phone:781-749-8730
Mailing Address - Fax:781-749-2356
Practice Address - Street 1:100 DERBY ST
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4210
Practice Address - Country:US
Practice Address - Phone:781-749-8730
Practice Address - Fax:781-749-2356
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist