Organization Active NPI

Northeast Pharmacy Services LLC

  • Long Term Care Pharmacy
  • Concord, NH
National Provider Identifier
1144321357
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
0655 Issued in NH
Legal business name
NORTHEAST PHARMACY SERVICES LLC
Practice address
1 Granite PL
Suite 200 North
Concord, NH 03301-3258
Phone
(603) 224-9591
Fax
(603) 225-6579
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Authorized official

Name
Mr. Charles John Fanaras, RPH
Title
Ceo
Phone
(603) 223-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 0655 NH Primary

Addresses

Primary practice location

1 Granite PL
Suite 200 North
Concord, NH 03301-3258

Mailing address

1 Granite PL
Suite 200 North
Concord, NH 03301-3258
Phone (603) 224-9591

Other identifiers 3

IdentifierTypeStateIssuer
3007095OtherNHNABP
3077603MedicaidNH
0655POtherNHNEW HAMPSHIRE BOARD OF PHARMACY

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1 Granite Pl
Ste N200
Concord, NH 03301
Phone (603) 226-8686

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1144321357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GRANITE PL",
            "address_2": "SUITE 200 NORTH",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013258",
            "telephone_number": "603-224-9591",
            "fax_number": "603-225-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANITE PL",
            "address_2": "SUITE 200 NORTH",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013258",
            "telephone_number": "603-224-9591",
            "fax_number": "603-225-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "FANARAS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "603-223-3111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NH",
            "license": "0655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3007095",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077603",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW HAMPSHIRE BOARD OF PHARMACY",
            "identifier": "0655P",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.

Verify at the official NPI Registry.