Umass Memorial Medical Center, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

DS89822 Issued in MA

Legal business name

UMASS MEMORIAL MEDICAL CENTER, INC.

Doing business as

UMass Memorial Medical Center Specialty Pharmacy

Practice address

55 Lake Ave N Ste Ac1.033
Worcester, MA 01655-0002

Phone

(888) 639-3988

Fax

(866) 344-0186

NPI assigned

Feb 3, 2012

Last updated

Aug 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Smith

Title

Director, Specialty Pharmacy

Phone

(508) 740-8131

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• UMass Memorial Medical Center Specialty Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Marlborough, MA
  • NPI 1396738159

  6204745904

  Same PAC ID
• Umass Memorial Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Worcester, MA
  • NPI 1689760092

  6204745904

  Same PAC ID
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455

  6204745904

  Same PAC ID

Locations

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.

• Kyle D Macdonald, PHARMD

  • Pharmacist
  • Worcester, MA
  • NPI 1558770453
  NPD (past)

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1831461086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "SUITE AC1.033",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "888-639-3988",
            "fax_number": "866-344-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N STE AC1.033",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "888-639-3988",
            "fax_number": "866-344-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMASS MEMORIAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DIRECTOR, SPECIALTY PHARMACY",
        "authorized_official_telephone_number": "508-740-8131"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "DS89822",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093140",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135484",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMass Memorial Medical Center Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Umass Memorial Medical Center, Inc. (UMass Memorial Medical Center Specialty Pharmacy)
• Umass Memorial Medical Center, Inc. (Prescription Center Pharmacy)
• Umass Memorial Medical Center, Inc.
• Umass Memorial Medical Center, Inc. (UMass Memorial Home Health)
• Umass Memorial Medical Center, Inc.
• Umass Memorial Medical Center, Inc. (Prescription Center Pharmacy)
• Umass Memorial Medical Group Inc
• Umass Memorial Medical Group, Inc.
• Umass Memorial MRI & Imaging Center LLC (Shields MRI at UMass Memorial)
• Umass Memorial MRI & Imaging Center, LLC

• Community/Retail Pharmacy in Worcester, MA
• Providers in Worcester, MA by specialty
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.