Pawtucket Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

789 Issued in MA

Legal business name

PAWTUCKET PHARMACY INC

Doing business as

Pawtucket Pharmacy Inc

Practice address

65 School St
Lowell, MA 01854-3239

Phone

(978) 458-3366

Fax

(978) 454-5051

NPI assigned

Aug 30, 2006

Last updated

Jun 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bob Audet

Title

Owner

Phone

(978) 458-3366

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PAWTUCKET PHARMACY INC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1134238355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 SCHOOL ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018543239",
            "telephone_number": "978-458-3366",
            "fax_number": "978-454-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 SCHOOL ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018543239",
            "telephone_number": "978-458-3366",
            "fax_number": "978-454-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWTUCKET PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "AUDET",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-458-3366"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417793",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2200789",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAWTUCKET PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kristi Lynn Pearsall, BA
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• Denise G Peaslee, MS.MED,LMHC
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• Community/Retail Pharmacy in Lowell, MA
• Providers in Lowell, MA by specialty
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.