Individual provider Active NPI

Alicia May Fullem, RPH, PHARMD

  • Pharmacist
  • Worcester, MA
National Provider Identifier
1598914079
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH232673 Issued in MA
Practice address
150 Lincoln St Apt 2
Worcester, MA 01605-2412
Phone
(302) 559-7545
NPI assigned
Sep 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH232673 MA Primary

Addresses

Primary practice location

150 Lincoln St Apt 2
Worcester, MA 01605-2412

Mailing address

150 Lincoln St Apt 2
Worcester, MA 01605-2412
Phone (302) 559-7545

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH232673MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1598914079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LINCOLN ST APT 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052412",
            "telephone_number": "302-559-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 LINCOLN ST APT 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052412",
            "telephone_number": "302-559-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLEM",
        "first_name": "ALICIA",
        "middle_name": "MAY",
        "name_prefix": "Ms.",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH232673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 29, 2011; 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.