Organization Active NPI

RPH LLC

Doing business as Village Pharmacy of Marblehead

  • Community/Retail Pharmacy
  • Marblehead, MA
National Provider Identifier
1740826908
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200529000428 MA Part B Supplier - Mass Immunization (Roster Biller Only) 0941630388 Practice locations: Marblehead, MA

National Provider Directory

National Provider Directory

Ownership & 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.

Verify at the official NPI Registry.