Active NPI
Sandy Mac
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Medford, MA
National Provider Identifier
1093335101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 236913
- Practice address
- 85 High St
Medford, MA 02155-3825 - Phone
- (781) 396-4770
- NPI assigned
- Apr 17, 2020
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 236913 | MA | Primary |
Addresses
Primary practice location
85 High St
Medford, MA 02155-3825
Mailing address
85 High St
Medford, MA 02155-3825
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 |
|---|---|---|---|
| 236913 | MA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631404800000",
"number": "1093335101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 HIGH ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021553825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 HIGH ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021553825",
"telephone_number": "781-396-4770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAC",
"first_name": "SANDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-17",
"last_updated": "2021-09-12",
"certification_date": "2021-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MA",
"license": "236913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.