Provider Demographics
NPI:1871847137
Name:PHARMAHEALTH SPECIALTY/LONGTERM CARE, INC.
Entity Type:Organization
Organization Name:PHARMAHEALTH SPECIALTY/LONGTERM CARE, INC.
Other - Org Name:PHARMAHEALTH SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FALZARANO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:508-998-8000
Mailing Address - Street 1:132 ALDEN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4721
Mailing Address - Country:US
Mailing Address - Phone:508-998-8000
Mailing Address - Fax:508-998-1145
Practice Address - Street 1:75 AMORY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-1051
Practice Address - Country:US
Practice Address - Phone:877-737-0047
Practice Address - Fax:508-998-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3336C0003X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy