Provider Demographics
NPI:1487764841
Name:POND, SCOTT THOMAS (RPH, MPA)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:THOMAS
Last Name:POND
Suffix:
Gender:M
Credentials:RPH, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 ELM ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1563
Mailing Address - Country:US
Mailing Address - Phone:617-972-5317
Mailing Address - Fax:617-972-5326
Practice Address - Street 1:485 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-5091
Practice Address - Country:US
Practice Address - Phone:617-972-5317
Practice Address - Fax:617-972-5326
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA16749OtherMASS PHARMACY LICENSE