Individual provider Active NPI

Nancy Guillaume, PHARMD

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1700628492
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PI124754 Issued in PA
Practice address
1240 N Taney St Apt C
Philadelphia, PA 19121-5082
Phone
(908) 346-1688
NPI assigned
Jun 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PI124754 PA Primary

Addresses

Primary practice location

1240 N Taney St Apt C
Philadelphia, PA 19121-5082

Mailing address

1240 N Taney St Apt C
Philadelphia, PA 19121-5082
Phone (908) 346-1688

Other practice location 1

927 Providence Rd
Secane, PA 19018-2919
Phone (610) 284-3270

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

State licenses

LicenseStateTypeSpecialty
PI124754PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania CVS Pharmacy, L.L.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1700628492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 N TANEY ST APT C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191215082",
            "telephone_number": "908-346-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N TANEY ST APT C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191215082",
            "telephone_number": "908-346-1688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Providence Rd",
            "address_purpose": "LOCATION",
            "city": "Secane",
            "state": "PA",
            "postal_code": "190182919",
            "country_code": "US",
            "telephone_number": "610-284-3270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUILLAUME",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "PI124754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.