Individual provider Active NPI

Clark Edward Imperioso, RPH

  • Pharmacist
  • Chelmsford, MA
National Provider Identifier
1336384437
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH21374 Issued in MA
Practice address
10 Industrial Ave
Chelmsford, MA 01824-3610
Phone
(978) 244-1301
NPI assigned
Dec 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH21374 MA Primary

Addresses

Primary practice location

10 Industrial Ave
Chelmsford, MA 01824-3610

Mailing address

10 Industrial Ave
Chelmsford, MA 01824-3610
Phone (978) 244-1301

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

LicenseStateTypeSpecialty
PH21374MAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1336384437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 INDUSTRIAL AVE",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018243610",
            "telephone_number": "978-244-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 INDUSTRIAL AVE",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018243610",
            "telephone_number": "978-244-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERIOSO",
        "first_name": "CLARK",
        "middle_name": "EDWARD",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH21374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.