Pelham Community Pharmacy, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

DS89647 Issued in MA

Legal business name

PELHAM COMMUNITY PHARMACY, INC

Practice address

21 Green St
Waltham, MA 02451-1646

Phone

(781) 966-2700

Fax

(781) 890-0234

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Bhuren PatelNPI 1255662201

Title

Owner

Phone

(781) 966-2700

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PELHAM COMMUNITY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MA2 enrollments

Enrollment records 2

Locations

Practitioners 5

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

• Bhuren Harish Patel, R.PH.

  • Pharmacist
  • Waltham, MA
  • NPI 1255662201
  NPD Authorized official
• Jeffrey Russell Arredondo, PHARMD

  • Pharmacist
  • North Waltham, MA
  • NPI 1053990721
  NPD (past)
• Aimee L Drew, PHARM D.

  • Pharmacist
  • Waltham, MA
  • NPI 1003495631
  NPD (past)
• Taylor Fitch, PHARMD

  • Pharmacist
  • Waltham, MA
  • NPI 1609592880
  NPD (past)
• Denise Smigielski, RPH

  • Pharmacist
  • Waltham, MA
  • NPI 1962081729
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1598889172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GREEN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511646",
            "telephone_number": "781-966-2700",
            "fax_number": "781-890-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GREEN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511646",
            "telephone_number": "781-966-2700",
            "fax_number": "781-890-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM COMMUNITY PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BHUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-966-2700"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MA",
            "license": "DS89647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0407810",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2237837",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PELHAM COMMUNITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PELHAM COMMUNITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peace of Mind Therapy
• Kerry M Pearl, M.S., CCC-SLP
• Rebecca L Pearsall, LICSW
• Jayda Pearson
• Micayla Brianne Pedrick, PT, DPT
• April May Pellegrini
• Kristen Amy Pellerin
• Elena Peltola, CPS
• Yifan Peng
• Alan Stewart Penzias, M.D.

• Long Term Care Pharmacy in Waltham, MA
• Providers in Waltham, MA by specialty
• Long Term Care Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare 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.