Active NPI
Phily Le Rivera
- Pharmacist
- Holden, MA
National Provider Identifier
1942896964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH239942
- Practice address
- 1145 Main St
Holden, MA 01520-1221 - Phone
- (508) 829-1780
- NPI assigned
- Dec 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH239942 | MA | Primary |
Addresses
Primary practice location
1145 Main St
Holden, MA 01520-1221
Mailing address
1145 Main St
Holden, MA 01520-1221
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | n/a |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH239942 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1145 Main St
Holden, MA 01520
Phone (508) 829-1780
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609459200000",
"number": "1942896964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 MAIN ST",
"city": "HOLDEN",
"state": "MA",
"postal_code": "015201221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 MAIN ST",
"city": "HOLDEN",
"state": "MA",
"postal_code": "015201221",
"telephone_number": "508-829-1780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "PHILY",
"middle_name": "LE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-14",
"last_updated": "2021-01-01",
"certification_date": "2021-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH239942",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "n/a",
"affiliation": "N",
"address_1": "1145 Main St",
"city": "Holden",
"state": "MA",
"country_code": "US",
"postal_code": "015201221",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 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.