Active NPI
Claudette Irene Mullen
- Pharmacist
- Edgartown, MA
National Provider Identifier
1114521994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- MA21414
- Practice address
- 245 Vineyard Haven Road
Edgartown, MA 02539-2368 - Phone
- (508) 627-5107
- Fax
- (844) 411-6348
- NPI assigned
- Nov 23, 2020
- 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 | MA21414 | MA | Primary |
Addresses
Primary practice location
245 Vineyard Haven Road
Edgartown, MA 02539-2368
Mailing address
PO Box 1887
Oak Bluffs, MA 02557-1887
Phone (401) 450-6670
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 |
|---|---|---|---|
| MA21414 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1114521994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1887",
"city": "OAK BLUFFS",
"state": "MA",
"postal_code": "025571887",
"telephone_number": "401-450-6670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 VINEYARD HAVEN ROAD",
"city": "EDGARTOWN",
"state": "MA",
"postal_code": "025392368",
"telephone_number": "508-627-5107",
"fax_number": "844-411-6348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "CLAUDETTE",
"middle_name": "IRENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "MA21414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edgartown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.