Active NPI
Gerard P. Bouchard, RPH
- Pharmacist
- Brunswick, ME
National Provider Identifier
1487773412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR2767
- Practice address
- 121 Medical Center Dr
Suite G-500
Brunswick, ME 04011-2653 - Phone
- (207) 729-3642
- Fax
- (207) 729-2704
- NPI assigned
- Mar 29, 2007
- 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 | PR2767 | ME | Primary |
Addresses
Primary practice location
121 Medical Center Dr
Suite G-500
Brunswick, ME 04011-2653
Mailing address
121 Medical Center Drive
Suite G-500
Brunswick, ME 04011
Phone (207) 729-3642
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
| License | State | Type | Specialty |
|---|---|---|---|
| PR2767 | ME | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennebec Pharmacy and Home Care 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.
-
- Oxygen Equipment & Supplies (DME)
- Brunswick, ME
- NPI 1063445625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487773412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 MEDICAL CENTER DRIVE",
"address_2": "SUITE G-500",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "04011",
"telephone_number": "207-729-3642",
"fax_number": "207-729-2704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 MEDICAL CENTER DR",
"address_2": "SUITE G-500",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040112653",
"telephone_number": "207-729-3642",
"fax_number": "207-729-2704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHARD",
"first_name": "GERARD",
"middle_name": "P.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR2767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.