NPIMap

Organization Active NPI

Westport Apothecary Inc

  • Community/Retail Pharmacy
  • Westport, MA
National Provider Identifier
1942308317
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
14815 Issued in MA
Legal business name
WESTPORT APOTHECARY INC
Practice address
784 Main Rd
Westport, MA 02790-4341
Phone
(508) 636-5957
Fax
(508) 636-6697
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Authorized official

Name
Lynne Barker, BS IN PHARMACYNPI 1104358423
Title
General Manager
Phone
(508) 636-5957

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
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 14815 MA Primary

Addresses

Primary practice location

784 Main Rd
Westport, MA 02790-4341

Mailing address

784 Main Rd
Westport, MA 02790-4341
Phone (508) 636-5957

Other identifiers 4

IdentifierTypeStateIssuer
WA00393MedicaidRI
0426733MedicaidMA
2039645OtherPK
1942308317MedicaidRI

Other names 1

  • WESTPORT APOTHECARY INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930075551 MA DME Supplier - Pharmacy 9537285200 Practice locations: Westport, MA
O20101101000402 MA Part B Supplier - Mass Immunization (Roster Biller Only) 9537285200 Practice locations: Westport, MA
O20210104000993 MA Part B Supplier - Pharmacy 9537285200 Practice locations: Westport, MA

National Provider Directory

National Provider Directory
Tax ID family
Westport Apothecary Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1942308317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 MAIN RD",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027904341",
            "telephone_number": "508-636-5957",
            "fax_number": "508-636-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 MAIN RD",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027904341",
            "telephone_number": "508-636-5957",
            "fax_number": "508-636-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTPORT APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "508-636-5957",
        "authorized_official_credential": "BS IN PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "14815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WA00393",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0426733",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2039645",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942308317",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WESTPORT APOTHECARY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.