Provider Demographics
NPI:1689206997
Name:WESTPORT APOTHECARY INC
Entity Type:Organization
Organization Name:WESTPORT APOTHECARY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-636-5957
Mailing Address - Street 1:784 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4397
Mailing Address - Country:US
Mailing Address - Phone:508-636-5957
Mailing Address - Fax:508-636-6697
Practice Address - Street 1:784 MAIN RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4397
Practice Address - Country:US
Practice Address - Phone:508-636-5957
Practice Address - Fax:508-636-6697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy