Provider Demographics
NPI:1659413383
Name:CONLIN'S PHARMACY, INC.
Entity Type:Organization
Organization Name:CONLIN'S PHARMACY, INC.
Other - Org Name:RESIDENT CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-552-1777
Mailing Address - Street 1:30 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4449
Mailing Address - Country:US
Mailing Address - Phone:978-552-1700
Mailing Address - Fax:978-552-1785
Practice Address - Street 1:380 MERRIMACK ST
Practice Address - Street 2:UNIT 1B
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5870
Practice Address - Country:US
Practice Address - Phone:978-327-6551
Practice Address - Fax:978-327-6554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA900663336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110020809/AMedicaid