Provider Demographics
NPI:1972806917
Name:LYNCH, JEFFREY D
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:LYNCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MYLES STANDISH BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-7387
Mailing Address - Country:US
Mailing Address - Phone:800-966-3000
Mailing Address - Fax:508-427-5934
Practice Address - Street 1:350 MYLES STANDISH BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-7387
Practice Address - Country:US
Practice Address - Phone:800-966-3000
Practice Address - Fax:508-427-5934
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist