NPIMap

Organization Active NPI

Essentialrx

  • Long Term Care Pharmacy
  • Worcester, MA
National Provider Identifier
1518629591
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
ESSENTIALRX
Practice address
123 Summer St Ste 365
Worcester, MA 01608-1216
Phone
(508) 363-6602
Fax
(508) 363-7602
NPI assigned
Oct 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Kerry L Sam, PHARMDNPI 1124300728
Title
Pharmacy Manager
Phone
(508) 363-6602

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

123 Summer St Ste 365
Worcester, MA 01608-1216

Mailing address

123 Summer St Ste 365
Worcester, MA 01608-1216
Phone (508) 363-6602

Other identifiers 1

IdentifierTypeStateIssuer
110163939AMedicaidMA

Other names 1

  • EssentialRx LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Essentialrx2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 Summer St
Ste 365
Worcester, MA 01608
Phone (508) 363-6602

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1518629591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 365",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6602",
            "fax_number": "508-363-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 365",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6602",
            "fax_number": "508-363-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIALRX",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-07",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "SAM",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "508-363-6602",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110163939A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EssentialRx LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.