WORCESTER PHARMACY LLC (NPI# 1821139023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821139023 |
| Entity Type | Organization |
| Organization Name | WORCESTER PHARMACY LLC |
| Other Organization Name | BOULEVARD PHARMACEUTICAL COMPOUNDING CENTER |
| Practice Address |
149 Shrewsbury St Worcester MA 01604-4637 |
| Practice Telephone | 5087541791 |
| Practice Fax Number | 5087950813 |
| Mailing Telephone | 5087541791 |
| Mailing Fax Number | 5087950813 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-09-18 |
| Authorized Official Name | KHALID BOUKHATEM (OWNER) |
| Authorized Official Telephone | 6175992793 |
| Authorized Official Credential | PHARMD, RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | 2943 | MA | Laboratories |
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Boulevard Pharmaceutical Compounding Center | Doing Business As Name - Organization |
| Street Address |
149 SHREWSBURY ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01604-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
| 1285123034 | Sandra Jean Golden | Social Worker | 240 Belmont Street, Worcester, MA 01604 | 2018-05-08 |
| 1669961348 | Cindy Truong Choe | Behavior Technician | 330 Southwest Cutoff Suite 203, Worcester, MA 01604 | 2018-05-08 |
| 1013412915 | Michelle Marie Gaudet | Behavioral Analyst | 330 Southwest Cutoff, Suite 203, Worcester, MA 01604 | 2018-03-24 |
| 1104336593 | Younghwa Kim | Counselor | 2 Granite Street, Worcester, MA 01604 | 2017-10-11 |
| 1134640857 | Desiree Oquendo | Developmental Therapist | 43 Dillon Street, Worcester, MA 01604 | 2017-07-03 |
| 1457803686 | Reliable Home Care Services | Foster Care Agency | 35a Houghton Strret, Worcester, MA 01604 | 2016-11-04 |
| 1639530876 | Emily Capstick | Counselor | 81 Plantation Steet, Worcester, MA 01604 | 2016-03-16 |
| 1144696519 | Christian Caban I | Developmental Therapist | 25 Orient St, Worcester, MA 01604 | 2015-08-19 |
| 1750770160 | Ayanna Ortiz | Developmental Therapist | 16 Bangor St, Worcester, MA 01604 | 2015-01-22 |
| Find all providers in zip 01604 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932556438 | Procare Ltc of Ma LLC | Pharmacy | 155 Northboro Rd Ste 4, Southborough, MA 01772-1033 | 2016-05-16 |
| 1811233489 | Pharmahealth Inc | Pharmacy | 1167 N Main St, Randolph, MA 02368-2135 | 2012-12-29 |
| 1043527112 | Medi-son Solutions, LLC | Pharmacy | 898 Washington St, Suite B, Norwood, MA 02062-3446 | 2010-09-09 |
| 1285953992 | Integriscript, Inc. | Pharmacy | 95 Ashley Ave Ste B, West Springfield, MA 01089-1352 | 2010-05-19 |
| 1881856276 | New England Compounding Center | Pharmacy | 697 Waverly St, Framingham, MA 01702-8589 | 2008-06-27 |
| 1598889172 | Pelham Community Pharmacy, Inc | Pharmacy | 196 Bear Hill Rd, Waltham, MA 02451-1004 | 2007-03-19 |
| 1700931532 | D & M Powers, Inc. | Pharmacy | 1868 Centre St, West Roxbury, MA 02132-1902 | 2007-01-24 |
| 1225182595 | Village Fertility Pharmacy, LLC | Pharmacy | 335 Bear Hill Rd, Waltham, MA 02451-1006 | 2007-01-23 |
| 1952455206 | Sudbury Pharmacy Inc. | Pharmacy | 447 Boston Post Rd, Sudbury, MA 01776-3055 | 2007-01-23 |
| 1205989506 | Serio Brothers, Inc. | Pharmacy | 128 Main Street, Westminster, MA 01473-0446 | 2007-01-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.