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DERICK ANDERSON PHARMD

Pharmacy Service Providers Pharmacist

Provider NPI: 1093893984

Provider Information:
 DERICK  ANDERSON PHARMD
Gender: M
Not Sole Proprietor

Practice Location:
1180 BEACON ST  BROOKLINE, MA 02446-3885 US
Tel: 617-566-4080  Fax: 617-566-2757

Business Mailing Address:
50 STARK RD  DERRY, NH 03038-4611 US
Tel: 617-566-4080  Fax: --

NPI Information:
NPI: 1093893984
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
MA25168

Other Provider Identifiers:

IssuerNumberStateType
NEW HAMPSHIRE BOARD OF PHARMACYR1998NH01
MASSACHUSETTS BOARD OF PHARMACY25168MA01



American Medical Association 2012 taxonomy code information

Code: 183500000X

Type:

Classification:



Definition:



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