Active NPI
Brandon Emanuel Roque
- Pharmacist
- Fall River, MA
National Provider Identifier
1164036000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH237022
- Practice address
- 1512 S Main St
Fall River, MA 02724-2606 - Phone
- (508) 674-0255
- NPI assigned
- Sep 8, 2020
- 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 | PH237022 | MA | Primary |
Addresses
Primary practice location
1512 S Main St
Fall River, MA 02724-2606
Mailing address
1512 S Main St
Fall River, MA 02724-2606
Phone (508) 674-0255
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 |
|---|---|---|---|
| PH237022 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1164036000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 S MAIN ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027242606",
"telephone_number": "508-674-0255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1512 S MAIN ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027242606",
"telephone_number": "508-674-0255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUE",
"first_name": "BRANDON",
"middle_name": "EMANUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH237022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.