Provider Demographics
NPI:1922219534
Name:FOLSOM, ALDEN W JR (RPH)
Entity Type:Individual
Prefix:
First Name:ALDEN
Middle Name:W
Last Name:FOLSOM
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 GOSSELIN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-6145
Mailing Address - Country:US
Mailing Address - Phone:603-644-5639
Mailing Address - Fax:
Practice Address - Street 1:300 KELLER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3218
Practice Address - Country:US
Practice Address - Phone:603-621-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist