Individual provider Active NPI

Eric James Fosnock, PHARMD

  • Pharmacist
  • Methuen, MA
National Provider Identifier
1003405531
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH235209 Issued in MA
Practice address
380 Merrimack St Ste 1B
Methuen, MA 01844-5871
Phone
(978) 327-6551
Fax
(978) 327-6554
NPI assigned
Jan 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH235209 MA Primary

Addresses

Primary practice location

380 Merrimack St Ste 1B
Methuen, MA 01844-5871

Mailing address

380 Merrimack St Ste 1B
Methuen, MA 01844-5871
Phone (978) 327-6551

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH235209MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Conlin'S Pharmacy, Inc. PastSince Jan 17, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1003405531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST STE 1B",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445871",
            "telephone_number": "978-327-6551",
            "fax_number": "978-327-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST STE 1B",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445871",
            "telephone_number": "978-327-6551",
            "fax_number": "978-327-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSNOCK",
        "first_name": "ERIC",
        "middle_name": "JAMES",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH235209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.