Active NPI
Mireille Therenciel
- Pharmacist
- Dorchester, MA
National Provider Identifier
1568151918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH26255
- Practice address
- 757 Gallivan Blvd Ste 3
Dorchester, MA 02122-3188 - Phone
- (617) 282-5246
- NPI assigned
- May 2, 2023
- Last updated
- May 2, 2023
- Sex
- Female
- 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 | PH26255 | MA | Primary |
Addresses
Primary practice location
757 Gallivan Blvd Ste 3
Dorchester, MA 02122-3188
Mailing address
30 Belair Dr
Holbrook, MA 02343-1886
Phone (857) 222-8858
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 |
|---|---|---|---|
| PH26255 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Current | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Locations
757 Gallivan Blvd
Ste 3
Dorchester, MA 02122
Phone (617) 282-5246
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": "1682985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1568151918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BELAIR DR",
"city": "HOLBROOK",
"state": "MA",
"postal_code": "023431886",
"telephone_number": "857-222-8858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 GALLIVAN BLVD STE 3",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223188",
"telephone_number": "617-282-5246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THERENCIEL",
"first_name": "MIREILLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-02",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH26255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.