Active NPI
Warren Leo Holmberg Jr., RPH
- Pharmacist
- Vineyard Haven, MA
National Provider Identifier
1245827229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH19616
- Practice address
- 65 Main St
Vineyard Haven, MA 02568-5402 - Phone
- (508) 693-1010
- Fax
- (508) 693-6229
- NPI assigned
- Dec 24, 2020
- Last updated
- Dec 24, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH19616 | MA | Primary |
Addresses
Primary practice location
65 Main St
Vineyard Haven, MA 02568-5402
Mailing address
PO Box 417
Vineyard Haven, MA 02568-0417
Phone (508) 693-1010
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH19616 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| F.E. Leslie Druggist, Inc. | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Leslie's Pharmacy
- Community/Retail Pharmacy
- Vineyard Haven, MA
- NPI 1881601706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608768000000",
"number": "1245827229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417",
"city": "VINEYARD HAVEN",
"state": "MA",
"postal_code": "025680417",
"telephone_number": "508-693-1010",
"fax_number": "508-693-6229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 MAIN ST",
"city": "VINEYARD HAVEN",
"state": "MA",
"postal_code": "025685402",
"telephone_number": "508-693-1010",
"fax_number": "508-693-6229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMBERG",
"first_name": "WARREN",
"middle_name": "LEO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-24",
"last_updated": "2020-12-24",
"certification_date": "2020-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH19616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vineyard Haven, MA
- Hay Associates
- Jean Hay
- Health Imperatives Inc. (Martha's Vineyard Family Planning)
- Robert W Herman, DMD
- David Warren Holmberg, CPHT
- Marcy Emily Holmes, NP
- Hospice of Martha's Vineyard, Inc. (Hospice and Palliative Care of Martha's Vineyard)
- Hospice of Martha's Vineyard, Inc. (Hospice and Palliative Care of Martha's Vineyard)
- Katherine Mitchell Hough, ADULT NURSE PRACTITI
- Haven Huck
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.