Active NPI
Mary Boules
- Pharmacist
- Palmdale, CA
National Provider Identifier
1669988457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76501
- Practice address
- 3105 Rancho Vista Blvd
Palmdale, CA 93551-4822 - Phone
- (661) 538-1601
- NPI assigned
- Dec 16, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 76501 | CA | Primary |
Addresses
Primary practice location
3105 Rancho Vista Blvd
Palmdale, CA 93551-4822
Mailing address
40742 Oakmont CT
Palmdale, CA 93551-5641
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 |
|---|---|---|---|
| 76501 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Palmdale, CA
- NPI 1417066879
-
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513382400000",
"number": "1669988457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40742 OAKMONT CT",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935515641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 RANCHO VISTA BLVD",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935514822",
"telephone_number": "661-538-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULES",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-16",
"last_updated": "2017-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.