Provider Demographics
NPI:1871699355
Name:OLDEN'S PHARMACY INC.
Entity type:Organization
Organization Name:OLDEN'S PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MACARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:781-337-0187
Mailing Address - Street 1:101 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2400
Mailing Address - Country:US
Mailing Address - Phone:781-337-0187
Mailing Address - Fax:781-781-3311
Practice Address - Street 1:101 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2400
Practice Address - Country:US
Practice Address - Phone:781-337-0187
Practice Address - Fax:781-781-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA497223Medicaid