Individual provider Active NPI

David Warren Holmberg, CPHT

  • Pharmacy Technician
  • Vineyard Haven, MA
National Provider Identifier
1881281863
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
PT7115 Issued in MA
Practice address
65 Main St
Vineyard Haven, MA 02568-5402
Phone
(508) 693-1010
Fax
(508) 693-6229
NPI assigned
Dec 24, 2020
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X PT7115 MA Primary

Addresses

Primary practice location

65 Main St
Vineyard Haven, MA 02568-5402

Mailing address

PO Box 417
Vineyard Haven, MA 02568-0417
Phone (508) 693-1010

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
PT7115MAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
F.E. Leslie Druggist, Inc. CurrentSince Dec 21, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1881281863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025680417",
            "telephone_number": "508-693-1010",
            "fax_number": "508-693-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MAIN ST",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025685402",
            "telephone_number": "508-693-1010",
            "fax_number": "508-693-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMBERG",
        "first_name": "DAVID",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-24",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MA",
            "license": "PT7115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineyard Haven, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.