Active NPI
Olivia Anne Petkauskos, PHARMD
- Pharmacist
- Southborough, MA
National Provider Identifier
1033867767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH240682
- Practice address
- 78 Turnpike Rd
Southborough, MA 01772-2137 - Phone
- (508) 786-5980
- NPI assigned
- Mar 11, 2022
- Sex
- Female
- Sole proprietor
- No
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 | PH240682 | MA | Primary |
Addresses
Primary practice location
78 Turnpike Rd
Southborough, MA 01772-2137
Mailing address
528 Neck Rd
Lancaster, MA 01523-2273
Phone (978) 870-9871
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH240682 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
78 Turnpike Rd
Southborough, MA 01772
Phone (508) 786-5980
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1033867767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 NECK RD",
"city": "LANCASTER",
"state": "MA",
"postal_code": "015232273",
"telephone_number": "978-870-9871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 TURNPIKE RD",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017722137",
"telephone_number": "508-786-5980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETKAUSKOS",
"first_name": "OLIVIA",
"middle_name": "ANNE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-11",
"last_updated": "2022-03-11",
"certification_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH240682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.