Tracie Boudreau, RPH
Individual provider Active NPI Pharmacist · South Attleboro, MA
NPI 1275823940 · NPPES record last updated Apr 14, 2011
Key facts
- NPI
- 1275823940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH22832 (MA)
- Practice address
- 1099 Washington St
South Attleboro, MA 02703-7944 - Phone
- (508) 399-8070
- Fax
- (508) 761-6150
- NPI assigned
- Apr 14, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH22832 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH22832 | MA | Yes |
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
Other providers in South Attleboro, MA
- Bashir Ahmad
- Danica Elizabeth Aldrich
- BJS Wholesale Club Inc
- Donald T. Bobola
- Emily Catherine Bomba
- Caregivers HCP of Massachusetts LLC
- Michele Casoli-Reardon
- Amor-Lee Colombres
- Shana Neelu Coshal
- CVS Pharmacy Inc
All providers in South Attleboro, MA · Pharmacist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.