Provider Demographics
NPI:1700584141
Name:UNION PHARMACY, LLC
Entity type:Organization
Organization Name:UNION PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:XIAOYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-928-8455
Mailing Address - Street 1:103 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2201
Mailing Address - Country:US
Mailing Address - Phone:617-928-8455
Mailing Address - Fax:
Practice Address - Street 1:103 UNION ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2201
Practice Address - Country:US
Practice Address - Phone:617-928-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy