Maplewood Wellness Pharmacy Inc

Key facts

NPI: 1508334376
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
Legal business name: MAPLEWOOD WELLNESS PHARMACY INC
Practice address: 904 Salem St
Malden, MA 02148-4438
Phone: (781) 605-1775
NPI assigned: Nov 9, 2018
Organization subpart: No

Authorized official

Name: Mrs. Thao Huynh NPI 1609188366
Title: Pharmacy Manager
Phone: (781) 605-1775

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Thao T Huynh Pharmacist · Malden, MA · NPI 1609188366

NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20190408002613	MA	Part B Supplier - Mass Immunization (Roster Biller Only)	9739420308	Practice locations: Malden, MA

National Provider Directory

Locations

904 Salem St
Malden, MA 02148
Phone (781) 605-1775

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community/Retail Pharmacy	3336C0003X			Yes

Addresses

Primary practice location

904 Salem St
Malden, MA 02148-4438

Mailing address

904 Salem St
Malden, MA 02148-4438
Phone (781) 605-1775

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 16, 2019.

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1508334376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484438",
            "telephone_number": "781-605-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484438",
            "telephone_number": "781-605-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD WELLNESS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "THAO",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "781-605-1775",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

All providers in Malden, MA · Community/Retail Pharmacy in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.