Individual provider Active NPI

Eunice Kerubo Nyasani, PHARMD

  • Pharmacist
  • Athol, MA
National Provider Identifier
1578257390
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH241415 Issued in MA
Practice address
1640 S Main St
Athol, MA 01331-2162
Phone
(978) 249-9132
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH241415 MA Primary

Addresses

Primary practice location

1640 S Main St
Athol, MA 01331-2162

Mailing address

1640 S Main St
Athol, MA 01331-2162
Phone (978) 249-9132

Other names 1

  • Ms. Eunice K. Nyasani Other name

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH241415MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1578257390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S MAIN ST",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013312162",
            "telephone_number": "978-249-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S MAIN ST",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013312162",
            "telephone_number": "978-249-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYASANI",
        "first_name": "EUNICE",
        "middle_name": "KERUBO",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH241415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNICE",
            "last_name": "NYASANI",
            "middle_name": "K.",
            "prefix": "MS.",
            "credential": "PHARMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Athol, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.

Verify at the official NPI Registry.