Organization Active NPI

Conroy Apothecary Inc

  • Community/Retail Pharmacy
  • West Tisbury, MA
National Provider Identifier
1639239346
Registry record updated Dec 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1656 Issued in MA
Legal business name
CONROY APOTHECARY INC
Practice address
459 State Rd.
West Tisbury, MA 02575-0422
Phone
(508) 693-7070
Fax
(508) 693-7071
NPI assigned
Dec 11, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Tamara Hersh, RPH
Title
President
Phone
(508) 693-4558

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Conroy Apothecary Inc459 State Rd, West Tisbury, MA 02575-0422(508) 693-7070 Immunosuppressive Drugs|Nebulizer Drugs Does not accept assignmentParticipating since Aug 2, 1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930066420 MA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 1254452576 Practice locations: West Tisbury, MA
O20131017001663 MA Part B Supplier - Mass Immunization (Roster Biller Only) 1254452576 1 other NPI on this enrollment
Practice locations: West Tisbury, MA

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1656 MA
Community/Retail Pharmacy 3336C0003X 1656 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

459 State Rd.
West Tisbury, MA 02575-0422

Mailing address

PO Box 422
West Tisbury, MA 02575-0422
Phone (508) 693-7070

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0436216MedicaidMA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 26, 2011.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324857600000",
    "number": "1639239346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 422",
            "city": "WEST TISBURY",
            "state": "MA",
            "postal_code": "025750422",
            "telephone_number": "508-693-7070",
            "fax_number": "508-693-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 STATE RD.",
            "city": "WEST TISBURY",
            "state": "MA",
            "postal_code": "025750422",
            "telephone_number": "508-693-7070",
            "fax_number": "508-693-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROY APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-12-26",
        "status": "A",
        "authorized_official_last_name": "HERSH",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-693-4558",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "1656",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "1656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0436216",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Tisbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.