Active NPI
Minh Pham
- Pharmacist
- Enfield, CT
National Provider Identifier
1386256840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0014223
- Practice address
- 2 Shaker Rd
Enfield, CT 06082-3140 - Phone
- (860) 253-0463
- NPI assigned
- Aug 17, 2020
- Last updated
- Aug 17, 2020
- Sex
- Male
- 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 | PCT.0014223 | CT | Primary |
Addresses
Primary practice location
2 Shaker Rd
Enfield, CT 06082-3140
Mailing address
2 Shaker Rd
Enfield, CT 06082-3140
Phone (860) 253-0463
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 |
|---|---|---|---|
| PCT.0014223 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2 Shaker Rd
Enfield, CT 06082
Phone (860) 253-0463
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1386256840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SHAKER RD",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823140",
"telephone_number": "860-253-0463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SHAKER RD",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823140",
"telephone_number": "860-253-0463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "MINH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0014223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.