Conroy Apothecary Inc
Organization Active NPI Pharmacy · Oak Bluffs, MA
NPI 1942513635 · NPPES record last updated Nov 12, 2014
Key facts
- NPI
- 1942513635
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- DS89729 (MA)
- Legal business name
- CONROY APOTHECARY INC
- Practice address
- 82 Pennacook Ave.
Oak Bluffs, MA 02557 - Phone
- (508) 696-0700
- Fax
- (508) 687-9541
- NPI assigned
- Jul 22, 2010
- Organization subpart
- No
Authorized official
- Name
- Tamara Hersh
- Title
- President
- Phone
- (508) 693-7070
Other NPIs on the same Medicare enrollment 1
Practitioners 1
-
Paula J Caron, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131017001663 | MA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1254452576 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: West Tisbury, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | DS89729 | MA | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
82 Pennacook Ave.
Oak Bluffs, MA 02557
Mailing address
PO Box 3349
82 Pennacook Ave
Oak Bluffs, MA 02557-3349
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110021805B | Medicaid | MA | |
| 2125961 | Other | PK |
Other names
- Conroy Apothecary OB
Other providers in Oak Bluffs, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.