Individual provider Active NPI

Dylan Ambrose

  • Pharmacist
  • Whitinsville, MA
National Provider Identifier
1730905878
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH1000319 Issued in MA
Practice address
100 Valley Pkwy
Whitinsville, MA 01588-1743
Phone
(508) 234-9196
NPI assigned
Nov 22, 2024
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 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 PH1000319 MA Primary

Addresses

Primary practice location

100 Valley Pkwy
Whitinsville, MA 01588-1743

Mailing address

105 Aspinet Rd
Eastham, MA 02642-1608

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

LicenseStateTypeSpecialty
PH1000319MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1730905878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ASPINET RD",
            "city": "EASTHAM",
            "state": "MA",
            "postal_code": "026421608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VALLEY PKWY",
            "city": "WHITINSVILLE",
            "state": "MA",
            "postal_code": "015881743",
            "telephone_number": "508-234-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH1000319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitinsville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.