Individual provider Active NPI

Amy Elizabeth Serino, PHARMD, RPH

  • Community/Retail Pharmacy
  • Plymouth, MA
National Provider Identifier
1205430386
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH239756 Issued in MA
Practice address
2253 State Rd
Plymouth, MA 02360-5150
Phone
(508) 833-3875
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH239756 MA Primary

Addresses

Primary practice location

2253 State Rd
Plymouth, MA 02360-5150

Mailing address

2253 State Rd
Plymouth, MA 02360-5150
Phone (508) 833-3875

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL RXNet

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
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH239756MAMDCommunity/Retail Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1205430386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 STATE RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605150",
            "telephone_number": "508-833-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 STATE RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605150",
            "telephone_number": "508-833-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERINO",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "PH239756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "RXNet",
            "affiliation": "N",
            "address_1": "2253 State Rd",
            "city": "Plymouth",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023605150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.