Provider Demographics
NPI:1851480545
Name:LYNNFIELD DRUG INC
Entity Type:Organization
Organization Name:LYNNFIELD DRUG INC
Other - Org Name:FREEDOM FERTILITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PERINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-684-6750
Mailing Address - Street 1:12 KENT WAY STE 120F
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-1221
Mailing Address - Country:US
Mailing Address - Phone:978-499-1400
Mailing Address - Fax:978-499-1500
Practice Address - Street 1:12 KENT WAY STE 120F
Practice Address - Street 2:
Practice Address - City:BYFIELD
Practice Address - State:MA
Practice Address - Zip Code:01922-1221
Practice Address - Country:US
Practice Address - Phone:008-660-4283
Practice Address - Fax:888-660-4283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2233916OtherOTHER ID NUMBER-COMMERCIAL NUMBER
MA=========Medicaid