Derek Tyler Borges
Pharmacist in New Bedford, MA. Individual provider (NPI-1).
NPI number1689201600
StatusActive
Last updated in NPPESMar 27, 2020
Details
- NPI
- 1689201600
- Entity type
- Individual (NPI-1)
- Name
- Derek Tyler Borges
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2020
- Certification date
- Mar 27, 2020
- Last updated
- Mar 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | PH239175 | MA | Yes |
Practice location
1207 Acushnet AveNew Bedford, MA 02746-2018
Phone 508-984-5402
Mailing address
1207 Acushnet AveNew Bedford, MA 02746-2018
Phone 508-984-5402
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