Provider Demographics
NPI:1962290460
Name:SULLIVAN, JOHN P (MS, PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:SULLIVAN
Suffix:
Gender:M
Credentials:MS, PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 CENTRAL STREET
Mailing Address - Street 2:
Mailing Address - City:FOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:02035
Mailing Address - Country:US
Mailing Address - Phone:508-543-6646
Mailing Address - Fax:508-698-9027
Practice Address - Street 1:67 CENTRAL STREET
Practice Address - Street 2:
Practice Address - City:FOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:02035
Practice Address - Country:US
Practice Address - Phone:508-543-6646
Practice Address - Fax:508-698-9027
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH1001193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty