Active NPI
Grace Mosallam, RPH
- Pharmacist
- West Boylston, MA
National Provider Identifier
1720828189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH997315
- Practice address
- 264 W Boylston St
West Boylston, MA 01583-1729 - Phone
- (781) 492-4895
- NPI assigned
- May 31, 2024
- Sex
- Female
- Sole proprietor
- No
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 | PH997315 | MA | Primary |
Addresses
Primary practice location
264 W Boylston St
West Boylston, MA 01583-1729
Mailing address
20 Hilltop St
North Grafton, MA 01536-1271
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH997315 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1720828189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 HILLTOP ST",
"city": "NORTH GRAFTON",
"state": "MA",
"postal_code": "015361271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 W BOYLSTON ST",
"city": "WEST BOYLSTON",
"state": "MA",
"postal_code": "015831729",
"telephone_number": "781-492-4895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSALLAM",
"first_name": "GRACE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH997315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Boylston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.