NPIMap

Organization Active NPI

Nkanyimuo Real Estate LLC

Doing business as Blue Hill Pharmacy

  • Community/Retail Pharmacy
  • Dorchester, MA
National Provider Identifier
1740615251
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
DS89942 Issued in MA
Legal business name
NKANYIMUO REAL ESTATE LLC
Doing business as
Blue Hill Pharmacy
Practice address
320 Blue Hill Ave
Store
Dorchester, MA 02121-1951
Phone
(617) 652-7546
Fax
(617) 652-7561
NPI assigned
Sep 4, 2013
Last updated
Jun 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Authorized official

Name
Ms. Victoria N Okeke, RPHNPI 1922432103
Title
Owner/ Pharmacist-in-Charge
Phone
(617) 652-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X DS89942 MA Primary

Addresses

Primary practice location

320 Blue Hill Ave
Store
Dorchester, MA 02121-1951

Mailing address

Blue Hill Pharmacy
320 Blue Hill Ave.
Dorchester, MA 02121-1951
Phone (617) 652-7546

Other identifiers 2

IdentifierTypeStateIssuer
110102251AMedicaidMA
2141994OtherPK

Other names 1

  • Blue Hill Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nkanyimuo Real Estate LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1740615251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLUE HILL PHARMACY",
            "address_2": "320 BLUE HILL AVE.",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021211951",
            "telephone_number": "617-652-7546",
            "fax_number": "617-652-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BLUE HILL AVE",
            "address_2": "STORE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021211951",
            "telephone_number": "617-652-7546",
            "fax_number": "617-652-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NKANYIMUO REAL ESTATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2023-06-29",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "OKEKE",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/ PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "617-652-7546",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "DS89942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110102251A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Hill Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.