Active NPI
Joseph Mark Bourque, RPH
- Pharmacist
- The Villages, FL
National Provider Identifier
1043657232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0023874
- Practice address
- 820 Old Camp Rd
The Villages, FL 32162-5611 - Phone
- (352) 753-7124
- Fax
- (352) 753-8534
- NPI assigned
- May 28, 2013
- Sex
- Male
- 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 | PS0023874 | FL | Primary |
Addresses
Primary practice location
820 Old Camp Rd
The Villages, FL 32162-5611
Mailing address
820 Old Camp Rd
The Villages, FL 32162-5611
Phone (352) 753-7124
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS0023874 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369699200000",
"number": "1043657232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 OLD CAMP RD",
"city": "THE VILLAGES",
"state": "FL",
"postal_code": "321625611",
"telephone_number": "352-753-7124",
"fax_number": "352-753-8534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 OLD CAMP RD",
"city": "THE VILLAGES",
"state": "FL",
"postal_code": "321625611",
"telephone_number": "352-753-7124",
"fax_number": "352-753-8534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURQUE",
"first_name": "JOSEPH",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-28",
"last_updated": "2013-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0023874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Villages, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.