East Bay Pharmacy Corp

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

EAST BAY PHARMACY CORP

Practice address

1565 N Main St Ste 502
Fall River, MA 02720-2972

Phone

(508) 813-8623

NPI assigned

Sep 3, 2021

Organization subpart

No

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

Authorized official

Name

Geoffrey Peterson, RPHNPI 1548605520

Title

President

Phone

(508) 813-8623

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Geoffrey David Peterson, PHARM.D

  • Pharmacist
  • North Providence, RI
  • NPI 1548605520
  NPD Authorized official

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1992473805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 N MAIN ST STE 502",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202972",
            "telephone_number": "508-689-9320",
            "fax_number": "508-689-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 N MAIN ST STE 502",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202972",
            "telephone_number": "508-813-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-813-8623",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Duval, PT
• Nathan Dworkin
• Mariah Faith Dwyer
• Shelby E Dykeman
• Daniel P Eardley, DO
• East Coast Clinical Health LLC
• East Coast Medical Associates PLLC
• East Main Pharmacy
• East Main Physical Therapy, Inc.
• East Side Counseling Services, LLC

• Long Term Care Pharmacy in Fall River, MA
• Providers in Fall River, 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 Nov 19, 2021; 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.