Individual provider Active NPI

Patricia Supczak, RPH

  • Pharmacist
  • Ludlow, MA
National Provider Identifier
1982351474
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25085 Issued in MA
Practice address
433 Center St Ste 3
Ludlow, MA 01056-2951
Phone
(413) 583-7910
NPI assigned
Mar 4, 2022
Last updated
Mar 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25085 MA Primary

Addresses

Primary practice location

433 Center St Ste 3
Ludlow, MA 01056-2951

Mailing address

9 Eliot LN
Wilbraham, MA 01095-1814
Phone (413) 221-4428

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
25085MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Big Y Foods, Inc PastSince Mar 6, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1982351474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ELIOT LN",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951814",
            "telephone_number": "413-221-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 CENTER ST STE 3",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010562951",
            "telephone_number": "413-583-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPCZAK",
        "first_name": "PATRICIA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "25085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludlow, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.