Active NPI
Pharma Service LLC
Doing business as Eterna Pharmacy
- Community/Retail Pharmacy
- New Bedford, MA
National Provider Identifier
1184194276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PHARMA SERVICE LLC
- Doing business as
- Eterna Pharmacy
- Practice address
- 1183 Acushnet Ave
New Bedford, MA 02746-1905 - Phone
- (508) 817-5044
- Fax
- (774) 305-4011
- NPI assigned
- Nov 30, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Felix Baez, RPH
- Title
- Pharmacist
- Phone
- (401) 486-4789
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Managed Care Organization Pharmacy | 3336M0003X |
Addresses
Primary practice location
1183 Acushnet Ave
New Bedford, MA 02746-1905
Mailing address
PO Box 2007
New Bedford, MA 02741-2007
Phone (401) 486-4789
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110148332A | Medicaid | MA |
Other names 1
- ETERNA PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190521002140 | MA | Part B Supplier - Mass Immunization (Roster Biller Only) | 6709127095 | Practice locations: New Bedford, MA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543536000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1640822400000",
"number": "1184194276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2007",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027412007",
"telephone_number": "401-486-4789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1183 ACUSHNET AVE",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027461905",
"telephone_number": "508-817-5044",
"fax_number": "774-305-4011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHARMA SERVICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-30",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A",
"authorized_official_last_name": "BAEZ",
"authorized_official_first_name": "FELIX",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "401-486-4789",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336M0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Managed Care Organization Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110148332A",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ETERNA PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "ETERNA PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.