Provider Demographics
NPI:1932705621
Name:CONCEPT PHARMACY SERVICES NEW ENGLAND LLC
Entity Type:Organization
Organization Name:CONCEPT PHARMACY SERVICES NEW ENGLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HILLEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-374-7300
Mailing Address - Street 1:21 TECHNOLOGY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-1632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 TECHNOLOGY DR STE 2
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1632
Practice Address - Country:US
Practice Address - Phone:603-374-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy