Provider Demographics
NPI:1104661511
Name:CROWN PHARMACY LLC
Entity type:Organization
Organization Name:CROWN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:617-335-4127
Mailing Address - Street 1:500 CONGRESS ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0917
Mailing Address - Country:US
Mailing Address - Phone:617-472-9000
Mailing Address - Fax:
Practice Address - Street 1:500 CONGRESS ST STE 1B
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0917
Practice Address - Country:US
Practice Address - Phone:617-472-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROWN PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy