Provider Demographics
NPI:1750006870
Name:MANNION, JOHN JAMES (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JAMES
Last Name:MANNION
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 1:275 MEDFORD ST APT 513
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02129-1993
Mailing Address - Country:US
Mailing Address - Phone:978-875-3838
Mailing Address - Fax:
Practice Address - Street 1:397 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1587
Practice Address - Country:US
Practice Address - Phone:781-894-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2411513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy