Provider Demographics
NPI:1649935339
Name:TON, BRYANT QUACH (RPH)
Entity type:Individual
Prefix:
First Name:BRYANT
Middle Name:QUACH
Last Name:TON
Suffix:
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 1:726 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-5542
Mailing Address - Country:US
Mailing Address - Phone:781-363-2527
Mailing Address - Fax:
Practice Address - Street 1:1515 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3082
Practice Address - Country:US
Practice Address - Phone:781-340-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist