Provider Demographics
NPI:1740231125
Name:MALONEY, DOUGLAS JAMES (PHARMSC, RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:JAMES
Last Name:MALONEY
Suffix:
Gender:M
Credentials:PHARMSC, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-2238
Mailing Address - Country:US
Mailing Address - Phone:617-773-1917
Mailing Address - Fax:
Practice Address - Street 1:22 INDEPENDENCE AVE
Practice Address - Street 2:CVS/PHARMACY #0686
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7703
Practice Address - Country:US
Practice Address - Phone:617-773-0558
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23302183500000X, 1835N1003X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric