Provider Demographics
NPI:1447488002
Name:POTTER, FREDRICK C (RPH)
Entity type:Individual
Prefix:
First Name:FREDRICK
Middle Name:C
Last Name:POTTER
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 1:4 BELGIAN PL
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3203
Mailing Address - Country:US
Mailing Address - Phone:603-566-8429
Mailing Address - Fax:
Practice Address - Street 1:331 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4601
Practice Address - Country:US
Practice Address - Phone:603-886-9210
Practice Address - Fax:603-886-1442
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist