Individual provider Active NPI

Alexander R Bourneuf, RPH

  • Pharmacist
  • Stratford, NJ
National Provider Identifier
1194320796
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04040500 Issued in NJ
Practice address
69 S White Horse Pike
Stratford, NJ 08084-1520
Phone
(856) 346-4138
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04040500 NJ Primary

Addresses

Primary practice location

69 S White Horse Pike
Stratford, NJ 08084-1520

Mailing address

69 S White Horse Pike
Stratford, NJ 08084-1520
Phone (856) 346-4138

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI04040500NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey CVS Pharmacy LLC CurrentSince Oct 24, 2021 Accepting new patients
New Jersey CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients

Locations

69 S White Horse Pike
Stratford, NJ 08084
Phone (856) 346-4138

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1194320796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 S WHITE HORSE PIKE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841520",
            "telephone_number": "856-346-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 S WHITE HORSE PIKE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841520",
            "telephone_number": "856-346-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNEUF",
        "first_name": "ALEXANDER",
        "middle_name": "R",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04040500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.