Provider Demographics
NPI:1184288326
Name:SPRINGFIELD PHARMACY LLC
Entity type:Organization
Organization Name:SPRINGFIELD PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:413-266-3462
Mailing Address - Street 1:2547 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1900
Mailing Address - Country:US
Mailing Address - Phone:413-266-3462
Mailing Address - Fax:413-266-3463
Practice Address - Street 1:2547 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1900
Practice Address - Country:US
Practice Address - Phone:413-266-3462
Practice Address - Fax:413-266-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy