NPIMap

Organization Active NPI

F.E. Leslie Druggist, Inc.

Doing business as Leslie's Pharmacy

  • Community/Retail Pharmacy
  • Vineyard Haven, MA
National Provider Identifier
1881601706
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
3302 Issued in MA
Legal business name
F.E. LESLIE DRUGGIST, INC.
Doing business as
Leslie's Pharmacy
leslies drug
Practice address
65 Main St
Vineyard Haven, MA 02568-5402
Phone
(508) 693-1010
Fax
(508) 693-6229
NPI assigned
Aug 2, 2006
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
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

Authorized official

Name
David Warren Holmberg, CPHT-ADVNPI 1881281863
Title
Store Manager / CPHT-Adv
Phone
(508) 693-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 3302 MA
Community/Retail Pharmacy 3336C0003X 3302 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

Other identifiers 2

IdentifierTypeStateIssuer
0495611MedicaidMA
2216275OtherMANCPDP

Other names 2

  • LESLIE'S PHARMACY Doing business as
  • leslies drug Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1881601706",
    "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": {
        "organization_name": "F.E. LESLIE DRUGGIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "HOLMBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "STORE MANAGER / CPHT-ADV",
        "authorized_official_telephone_number": "508-693-1010",
        "authorized_official_credential": "CPHT-ADV"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "3302",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "3302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0495611",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2216275",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LESLIE'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "leslies drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "leslies drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.