Provider Demographics
NPI:1982156279
Name:DO, LOC (RPH)
Entity Type:Individual
Prefix:
First Name:LOC
Middle Name:
Last Name:DO
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 1:246 BROADWAY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3044
Mailing Address - Country:US
Mailing Address - Phone:978-258-5828
Mailing Address - Fax:
Practice Address - Street 1:246 BROADWAY UNIT 2
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3044
Practice Address - Country:US
Practice Address - Phone:978-258-5828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4268183500000X
MAPH238830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist