Active NPI
Pine Hill Pharmacy LLC
Doing business as Pine Hill Pharmacy
- Community/Retail Pharmacy
- Sherborn, MA
National Provider Identifier
1285301929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PINE HILL PHARMACY LLC
- Doing business as
- Pine Hill Pharmacy
- Practice address
- 19 N Main St
Sherborn, MA 01770-1553 - Phone
- (508) 545-0946
- NPI assigned
- Aug 29, 2021
- Last updated
- Jan 7, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ali Ardakani, RPH
- Title
- Owner
- Phone
- (508) 545-0946
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
19 N Main St
Sherborn, MA 01770-1553
Mailing address
19 N Main St
Sherborn, MA 01770-1553
Other names 1
- Pine Hill Pharmacy
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Desktop |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211223001623 | MA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1254722473 | Practice locations: Sherborn, MA |
National Provider Directory
National Provider Directory- Tax ID family
- Pine Hill Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641513600000",
"number": "1285301929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 N MAIN ST",
"city": "SHERBORN",
"state": "MA",
"postal_code": "017701553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 N MAIN ST",
"city": "SHERBORN",
"state": "MA",
"postal_code": "017701553",
"telephone_number": "508-545-0946"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINE HILL PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-29",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A",
"authorized_official_last_name": "ARDAKANI",
"authorized_official_first_name": "ALI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "508-545-0946",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Desktop",
"affiliation": "N",
"address_1": "19 N Main St",
"city": "Sherborn",
"state": "MA",
"country_code": "US",
"postal_code": "017701553",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Pine Hill Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sherborn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.