Peter Harenberg, PHARMD, RPH

Individual provider Active NPI Pharmacist · Holbrook, MA

NPI 1134879570 · NPPES record last updated Dec 19, 2022

Key facts

NPI
1134879570
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PH240700 (MA)
Practice address
1 Plymouth St
Holbrook, MA 02343-1510
Phone
(780) 986-2172
Fax
(781) 986-2118
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH240700MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past
since Dec 28, 2022
Accepting new patients
Walgreen Co Past
since Dec 28, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH240700 MA Yes

Addresses

Primary practice location

1 Plymouth St
Holbrook, MA 02343-1510

Mailing address

1 Plymouth St
Holbrook, MA 02343-1510
Phone (781) 986-2172

Other practice location 1

250 Bayport Ave
Bayport, NY 11705-1853
Phone (631) 553-6349

Other providers in Holbrook, MA

All providers in Holbrook, MA · Pharmacist in Massachusetts

Sources for this page

Verify at the official NPI Registry.