NPIMap

Organization Active NPI

Northeast Pharmacy Services LLC

  • Long Term Care Pharmacy
  • Concord, NH
National Provider Identifier
1881817294
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
0655P Issued in NH
Legal business name
NORTHEAST PHARMACY SERVICES LLC
Practice address
1 Granite PL
Suite #200N
Concord, NH 03301-3258
Phone
(603) 224-9591
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Authorized official

Name
Mr. Charles John Fanaras, RPH
Title
Ceo
Phone
(603) 224-9591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 0655P NH Primary

Addresses

Primary practice location

1 Granite PL
Suite #200N
Concord, NH 03301-3258

Mailing address

1 Granite PL
Suite #200N
Concord, NH 03301-3258
Phone (603) 224-9591

Other identifiers 1

IdentifierTypeStateIssuer
3077603MedicaidNH

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1881817294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GRANITE PL",
            "address_2": "SUITE #200N",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013258",
            "telephone_number": "603-224-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANITE PL",
            "address_2": "SUITE #200N",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013258",
            "telephone_number": "603-224-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "FANARAS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "603-224-9591",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NH",
            "license": "0655P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077603",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.