Provider Demographics
NPI:1578944195
Name:DEMAMBRO, EUGENE FRANCIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:FRANCIS
Last Name:DEMAMBRO
Suffix:
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 1:12 RANDALL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-2021
Mailing Address - Country:US
Mailing Address - Phone:781-812-0520
Mailing Address - Fax:
Practice Address - Street 1:12 RANDALL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-2021
Practice Address - Country:US
Practice Address - Phone:781-812-0520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist