Provider Demographics
NPI:1598860827
Name:HARVARD PILGRIM HEALTH CARE
Entity Type:Organization
Organization Name:HARVARD PILGRIM HEALTH CARE
Other - Org Name:NASHUA MEDICAL GROUP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR - NMG
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-891-4411
Mailing Address - Street 1:173 DANIEL WEBSTER HWY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5224
Mailing Address - Country:US
Mailing Address - Phone:603-891-4411
Mailing Address - Fax:603-891-4410
Practice Address - Street 1:173 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5224
Practice Address - Country:US
Practice Address - Phone:603-891-4411
Practice Address - Fax:603-891-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0687P183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty