NPIMap

Organization Active NPI

Lahey Clinic Hospital, Inc.

Doing business as Lahey Clinic North Pharmacy

  • Pharmacy
  • Peabody, MA
National Provider Identifier
1689755746
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
MA0051158 Issued in MA
Legal business name
LAHEY CLINIC HOSPITAL, INC.
Doing business as
Lahey Clinic North Pharmacy
Practice address
1 Essex Center Dr
Peabody, MA 01960-2901
Phone
(978) 538-4150
Fax
(978) 538-4700
NPI assigned
Oct 17, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Joanne M Conroy, M.D.
Title
Chief Executive Officer
Phone
(781) 744-8594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X MA0051158 MA Primary

Addresses

Primary practice location

1 Essex Center Dr
Peabody, MA 01960-2901

Mailing address

1 Essex Center Dr
Peabody, MA 01960-2901
Phone (978) 538-4150

Other identifiers 2

IdentifierTypeStateIssuer
MA0051158OtherMACDS-MA
0443867MedicaidMA

Other names 1

  • LAHEY CLINIC NORTH PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930021909 MA DME Supplier - Optician 3678595311 Practice locations: Peabody, MA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lahey ClinicBurlington, MA, CCN 220171 Hospital Operational/Managerial Control Aug 18, 1980

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1689755746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602901",
            "telephone_number": "978-538-4150",
            "fax_number": "978-538-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602901",
            "telephone_number": "978-538-4150",
            "fax_number": "978-538-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAHEY CLINIC HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "781-744-8594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "MA0051158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS-MA",
            "identifier": "MA0051158",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443867",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAHEY CLINIC NORTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.