NPIMap

Individual provider Active NPI

Alexander Manjounes

  • Pharmacist
  • Watertown, MA
National Provider Identifier
1194483396
Registry record updated Dec 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH240402 Issued in MA
Practice address
27 Main St
Watertown, MA 02472-4404
Phone
(617) 926-6660
NPI assigned
Dec 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH240402 MA Primary

Addresses

Primary practice location

27 Main St
Watertown, MA 02472-4404

Mailing address

94 Keeley St
Haverhill, MA 01830-6641
Phone (978) 914-5219

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

LicenseStateTypeSpecialty
PH240402MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Meraki Pharmaceuticals Current Accepting new patients
CVS Pharmacy Inc CurrentSince Apr 24, 2022 Accepting new patients
CVS Pharmacy Inc PastSince Dec 12, 2021 Accepting new patients

Locations

27 Main St
Watertown, MA 02472
Phone (617) 926-6660

Organizations & group practices 3

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": "1638576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638576000000",
    "number": "1194483396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 KEELEY ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306641",
            "telephone_number": "978-914-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MAIN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724404",
            "telephone_number": "617-926-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANJOUNES",
        "first_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-04",
        "last_updated": "2021-12-04",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH240402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2021; 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.