Active NPI
Tracie Boudreau, RPH
- Pharmacist
- South Attleboro, MA
National Provider Identifier
1275823940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH22832
- Practice address
- 1099 Washington St
South Attleboro, MA 02703-7944 - Phone
- (508) 399-8070
- Fax
- (508) 761-6150
- NPI assigned
- Apr 14, 2011
- Last updated
- Apr 14, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH22832 | MA | Primary |
Addresses
Primary practice location
1099 Washington St
South Attleboro, MA 02703-7944
Mailing address
807 Paine Rd
North Attleboro, MA 02760-6218
Phone (508) 643-9557
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 |
|---|---|---|---|
| PH22832 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1275823940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 PAINE RD",
"city": "NORTH ATTLEBORO",
"state": "MA",
"postal_code": "027606218",
"telephone_number": "508-643-9557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1099 WASHINGTON ST",
"city": "SOUTH ATTLEBORO",
"state": "MA",
"postal_code": "027037944",
"telephone_number": "508-399-8070",
"fax_number": "508-761-6150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAU",
"first_name": "TRACIE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-14",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH22832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Attleboro, MA
- Bashir Ahmad, M.D.
- Danica Elizabeth Aldrich, MA, LMHC
- BJS Wholesale Club Inc (BJS Pharmacy)
- Donald T. Bobola, PMHCNS - BC
- Emily Catherine Bomba, LMT
- Caregivers HCP of Massachusetts LLC (Caregivers Management Company)
- Michele Casoli-Reardon, MD
- Amor-Lee Colombres
- Shana Neelu Coshal, M.D., M.P.H.
- CVS Pharmacy Inc (CVS Pharmacy # 02206)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.