UMASS MEMORIAL MEDICAL CENTER, INC. (NPI# 1831461086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831461086 |
| Entity Type | Organization |
| Organization Name | UMASS MEMORIAL MEDICAL CENTER, INC. |
| Other Organization Name | UMASS MEMORIAL MEDICAL CENTER SPECIALTY PHARMACY |
| Practice Address |
55 Lake Ave N Ste Ac1.033 Worcester MA 01655-0002 |
| Mailing Address |
55 Lake Ave N Suite Ac1.033 Worcester MA 01655-0002 |
| Practice Telephone | 8886393988 |
| Practice Fax Number | 8663440186 |
| Mailing Telephone | 8886393988 |
| Mailing Fax Number | 8663440186 |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2016-08-02 |
| Authorized Official Name | BRIAN SMITH (DIRECTOR, SPECIALTY PHARMACY) |
| Authorized Official Telephone | 5087408131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
DS89822 | MA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110093140 | 05 | |
| PK | 2135484 | 01 |
| Other Name | Type Code |
|---|---|
| UMass Memorial Medical Center Specialty Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831151455 | Umass Memorial Medical Center, Inc. | General Acute Care Hospital | 55 Lake Avenue, Worcester, MA 01655 | 2006-04-06 |
| 1992068381 | Umass Memorial Medical Center, Inc. | Pharmacy | 119 Belmont St, Memorial Campus, Worcester, MA 01605-2903 | 2012-06-20 |
| 1174899280 | Umass Memorial Medical Center, Inc. | Pharmacy | 55 Lake Ave N, Worcester, MA 01655-0002 | 2012-03-23 |
| 1366714529 | Umass Memorial Medical Center, Inc. | Pharmacy | 55 Lake Ave N, Acc Building - 1st Floor - Suite Ac1.033, Worcester, MA 01655-0002 | 2012-02-03 |
| 1669630950 | Umass Memorial Medical Center, Inc. | Pharmacy | 119 Belmont St, Memorial Campus, Worcester, MA 01605-2903 | 2008-05-23 |
| 1689760092 | Umass Memorial Medical Center, Inc. | Psychiatric Unit | 55 Lake Ave N, Worcester, MA 01655-0002 | 2006-10-04 |
| 1770526527 | Umass Memorial Medical Center, Inc. | Home Health | 650 Lincoln St, Worcester, MA 01605-2011 | 2006-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | UMASS MEMORIAL MEDICAL CENTER, INC. | One Biotech, 365 Plantation Street, Worcester, MA 01605 |
| Street Address |
55 LAKE AVE N STE AC1.033 |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558770453 | Kyle D Macdonald | Pharmacist | 55 Lake Ave N Ste Ac1.033, Worcester, MA 01655-0002 | 2014-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1568679439 | Walgreen Co | Pharmacy | 472 Lincoln St., Worcester, MA 01605-1917 | 2007-05-17 |
| 1669528360 | Haig & Haig Drug Inc | Pharmacy | 550 W Boylston St, Worcester, MA 01606-2027 | 2007-01-26 |
| 1295834661 | Cvs Pharmacy Inc | Pharmacy | 50 Sw Cutoff, Worcester, MA 01604-1534 | 2006-09-22 |
| 1093814451 | Cvs Pharmacy Inc | Pharmacy | 256 Lincoln St, Worcester, MA 01605-2105 | 2006-09-22 |
| 1225137672 | Cvs Pharmacy Inc | Pharmacy | 481 Lincoln St, Worcester, MA 01605-1915 | 2006-09-22 |
| 1558460915 | Cvs Pharmacy Inc | Pharmacy | 500 Grafton St, Worcester, MA 01604-4713 | 2006-09-22 |
| 1134228596 | Cvs Pharmacy Inc | Pharmacy | 638 Chandler St, Worcester, MA 01602-1770 | 2006-09-22 |
| 1215036660 | Cvs Pharmacy Inc | Pharmacy | 110 Front St Ste 102, Worcester, MA 01608-1446 | 2006-09-22 |
| Find all providers in WORCESTER | ||||
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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.