Provider Demographics
NPI:1952860801
Name:UNION PHARMACY, LLC
Entity Type:Organization
Organization Name:UNION PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:XIAOYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:617-304-7477
Mailing Address - Street 1:63 SUFFOLK RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2601
Mailing Address - Country:US
Mailing Address - Phone:617-304-7477
Mailing Address - Fax:
Practice Address - Street 1:103 UNION ST
Practice Address - Street 2:
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-2201
Practice Address - Country:US
Practice Address - Phone:617-304-7477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy