Provider Demographics
NPI:1447039169
Name:LANGLEY, LOGAN JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:JAMES
Last Name:LANGLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 VFW PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3620
Mailing Address - Country:US
Mailing Address - Phone:802-735-5776
Mailing Address - Fax:
Practice Address - Street 1:647 VFW PKWY
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3656
Practice Address - Country:US
Practice Address - Phone:617-469-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH997118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist