Provider Demographics
NPI:1639648645
Name:O'NEIL, JOHN ROGER (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROGER
Last Name:O'NEIL
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 1:89 FRENCH KING HWY
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1387
Mailing Address - Country:US
Mailing Address - Phone:413-592-7569
Mailing Address - Fax:
Practice Address - Street 1:89 FRENCH KING HWY
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1387
Practice Address - Country:US
Practice Address - Phone:413-774-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist