Active NPI
RPH LLC
Doing business as Village Pharmacy of Marblehead
- Community/Retail Pharmacy
- Marblehead, MA
National Provider Identifier
1740826908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- RPH LLC
- Doing business as
- Village Pharmacy of Marblehead
- Practice address
- 1 Village PLZ
Marblehead, MA 01945-2373 - Phone
- (781) 631-8100
- Fax
- (781) 639-2919
- NPI assigned
- Nov 22, 2019
- Last updated
- Nov 22, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sabino Russo, RPH
- Title
- Owner/Pharmacist
- Phone
- (781) 631-8100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1 Village PLZ
Marblehead, MA 01945-2373
Mailing address
1 Village PLZ
Marblehead, MA 01945-2373
Phone (781) 631-8100
Other names 1
- Village Pharmacy of Marblehead
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200529000428 | MA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0941630388 | Practice locations: Marblehead, MA |
National Provider Directory
National Provider DirectoryOwnership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1574380800000",
"number": "1740826908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 VILLAGE PLZ",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019452373",
"telephone_number": "781-631-8100",
"fax_number": "781-639-2919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VILLAGE PLZ",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019452373",
"telephone_number": "781-631-8100",
"fax_number": "781-639-2919"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RPH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-22",
"last_updated": "2019-11-22",
"status": "A",
"authorized_official_last_name": "RUSSO",
"authorized_official_first_name": "SABINO",
"authorized_official_title_or_position": "OWNER/PHARMACIST",
"authorized_official_telephone_number": "781-631-8100",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Village Pharmacy of Marblehead",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Marblehead, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.