Provider Demographics
NPI:1760599401
Name:ALLIE, EDWARD CHARLES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHARLES
Last Name:ALLIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2535
Mailing Address - Country:US
Mailing Address - Phone:781-366-5244
Mailing Address - Fax:781-493-7909
Practice Address - Street 1:30 PERWAL ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1928
Practice Address - Country:US
Practice Address - Phone:781-493-7955
Practice Address - Fax:781-493-7909
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA248041835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy