NPIMap

Organization Active NPI

Boltons Pharmacy Inc

Doing business as Bolton's Pharmacy

  • Long Term Care Pharmacy
  • Watertown, NY
National Provider Identifier
1699319335
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
BOLTONS PHARMACY INC
Doing business as
Bolton's Pharmacy
Practice address
128 W Main St
Watertown, NY 13601-1989
Phone
(315) 782-5961
Fax
(315) 782-4496
NPI assigned
Nov 6, 2019
Last updated
Jul 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
Coleen Signor, RPH
Title
Owner
Phone
(315) 782-5961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

128 W Main St
Watertown, NY 13601-1989

Mailing address

128 W Main St
Watertown, NY 13601-1989
Phone (315) 782-5961

Other identifiers 1

IdentifierTypeStateIssuer
01077238MedicaidNY

Other names 1

  • Bolton's Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bolton's Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

128 W Main St
Watertown, NY 13601
Phone (315) 782-5961

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1699319335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011989",
            "telephone_number": "315-782-5961",
            "fax_number": "315-782-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011989",
            "telephone_number": "315-782-5961",
            "fax_number": "315-782-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLTONS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "SIGNOR",
        "authorized_official_first_name": "COLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-782-5961",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01077238",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolton's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bolton's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.