Active NPI
Erica Debra Boodoo, CHPT
- Pharmacy Technician
- Plymouth Meeting, PA
National Provider Identifier
1205056348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 380100106111057
- Practice address
- 2250 Hickory Road
Suite 240
Plymouth Meeting, PA 19462 - Phone
- (800) 879-4471
- Fax
- (610) 834-7525
- NPI assigned
- Apr 30, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 380100106111057 | MD | Primary |
Addresses
Primary practice location
2250 Hickory Road
Suite 240
Plymouth Meeting, PA 19462
Mailing address
1441 Bonsal Street
Baltimore, MD 21224
Phone (443) 846-2111
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 |
|---|---|---|---|
| 380100106111057 | MD | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205056348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 BONSAL STREET",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21224",
"telephone_number": "443-846-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 HICKORY ROAD",
"address_2": "SUITE 240",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "19462",
"telephone_number": "800-879-4471",
"fax_number": "610-834-7525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOODOO",
"first_name": "ERICA",
"middle_name": "DEBRA",
"credential": "CHPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MD",
"license": "380100106111057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth Meeting, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.