Active NPI
Mary Woodall
- Pharmacist
- Windham, ME
National Provider Identifier
1023572732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR47099
- Practice address
- 770 Roosevelt TRL
Windham, ME 04062-5300 - Phone
- (207) 892-2541
- NPI assigned
- Jan 27, 2019
- Last updated
- Jan 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR47099 | ME | Primary |
Addresses
Primary practice location
770 Roosevelt TRL
Windham, ME 04062-5300
Mailing address
100 Harvest Hill Rd
Windham, ME 04062-5789
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR47099 | ME | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS State Capital LLC | Past | Accepting new patients | |
| CVS State Capital LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548547200000",
"number": "1023572732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HARVEST HILL RD",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040625789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 ROOSEVELT TRL",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040625300",
"telephone_number": "207-892-2541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODALL",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-27",
"last_updated": "2019-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR47099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windham, ME
- Windham Dentistry LLC (Dental Office of Dr Leslie Elston)
- Windham Residential Care Facility (carols residential care facility)
- Windham Residential Care Facility
- Windham Residential Care Facility, Inc (Rest-a-Ville)
- John E. Wood, LADC
- Breanna Young
- Donna Lynne Zamrin, D.O.
- Kristen Joy Zoller, M.A., CF-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.