Provider Demographics
NPI:1679825426
Name:FREEL, TRACY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:FREEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6908
Mailing Address - Country:US
Mailing Address - Phone:603-626-6200
Mailing Address - Fax:603-626-7800
Practice Address - Street 1:8 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6908
Practice Address - Country:US
Practice Address - Phone:603-626-6200
Practice Address - Fax:603-626-7800
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1984183500000X
MAPH26463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist