Active NPI
Kwadwo Y Boachie
- Pharmacist
- Fredericksburg, VA
National Provider Identifier
1285238121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202207713
- Practice address
- 5701 Plank Rd
Fredericksburg, VA 22407-6227 - Phone
- (540) 758-1025
- NPI assigned
- Nov 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 0202207713 | VA | Primary |
Addresses
Primary practice location
5701 Plank Rd
Fredericksburg, VA 22407-6227
Mailing address
10124 Lees Crossing LN
Fredericksburg, VA 22408-0292
Phone (540) 424-7912
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 |
|---|---|---|---|
| 0202207713 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Parkville, MD
- NPI 1639938020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606003200000",
"number": "1285238121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10124 LEES CROSSING LN",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224080292",
"telephone_number": "540-424-7912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5701 PLANK RD",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224076227",
"telephone_number": "540-758-1025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOACHIE",
"first_name": "KWADWO",
"middle_name": "Y",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-22",
"last_updated": "2020-11-22",
"certification_date": "2020-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202207713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.