Procare LTC of Ma LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

DS90042 Issued in MA

Legal business name

PROCARE LTC OF MA LLC

Doing business as

Procare LTC of Ma, LLC

Practice address

155 Northboro Rd Ste 4
Southborough, MA 01772-1033

Phone

(508) 481-5800

Fax

(508) 481-5801

NPI assigned

May 16, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Bincy Varghese, PHARM D

Title

Director of Compliance

Phone

(888) 741-0367

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PROCARE LTC OF MA, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Anthony Hyde, R.PH

  • Pharmacist
  • Farmingdale, NY
  • NPI 1679799290
  NPD
• Thomas Lachapelle

  • Pharmacist
  • Southborough, MA
  • NPI 1285082149
  NPD (past)
• Timothy Wai Hung Lam

  • Pharmacist
  • Southborough, MA
  • NPI 1851836142
  NPD (past)
• Kreshnik Loxha

  • Pharmacist
  • Southborough, MA
  • NPI 1093250946
  NPD (past)
• Melissa Ostrander, RPH

  • Pharmacist
  • Southborough, MA
  • NPI 1447892492
  NPD (past)
• George Peter Roy, RPH

  • Pharmacist
  • Southborough, MA
  • NPI 1831601582
  NPD (past)
• Ioana Tompkins, RPH

  • Pharmacist
  • Southborough, MA
  • NPI 1447977483
  NPD (past)
• Minhchau Tran, PHARMD

  • Pharmacist
  • Southborough, MA
  • NPI 1053879601
  NPD (past)
• Leanne Languirand

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Louisville, KY
  • NPI 1417590357
  NPD (past)

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1932556438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OLYMPIC PL STE 600",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044110",
            "telephone_number": "888-741-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 NORTHBORO RD STE 4",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721033",
            "telephone_number": "508-481-5800",
            "fax_number": "508-481-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE LTC OF MA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "BINCY",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "888-741-0367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MA",
            "license": "DS90042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110115534A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160164",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROCARE LTC OF MA, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura J. Polvino, M.A., LMHC
• Monica Portilla
• Mallory Pracella
• Kathryn Woo Price, OTR/L
• Jonathan Christian Priehs
• Abigail Ann Purdy
• Quest Diagnostics Massachusetts LLC
• Usha S Rallapalli, M.D.
• Rose Clinton Randall
• Alisa Raniuk

• Long Term Care Pharmacy in Southborough, MA
• Providers in Southborough, MA by specialty
• Long Term Care Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.