Provider Demographics
NPI:1013612795
Name:MARLBORO PHARMACY AND WELLNESS CENTER
Entity Type:Organization
Organization Name:MARLBORO PHARMACY AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIANE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NOGAROTTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:978-808-0444
Mailing Address - Street 1:23 COACHLACE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-2407
Mailing Address - Country:US
Mailing Address - Phone:978-808-0444
Mailing Address - Fax:
Practice Address - Street 1:561 BOSTON POST RD E STE 1
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3775
Practice Address - Country:US
Practice Address - Phone:508-350-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy