Provider Type Icon

UPHAM'S CORNER HEALTH COMMITTEE INC. NPI 1023348638


NPI Information

NPI: 1023348638
Provider Name: UPHAM'S CORNER HEALTH COMMITTEE INC.

Doing Business As: UPHAM'S COMMUNITY CARE - PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 22D2009168

Address:
415 COLUMBIA RD
DORCHESTER, MA
ZIP 02125
Phone: (617) 265-1310
Get Directions

UPHAM'S CORNER HEALTH COMMITTEE INC. is a pharmacy in Dorchester, MA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. UPHAM'S CORNER HEALTH COMMITTEE INC. NPI is 1023348638. The provider is registered as an organization entity type.
The provider Is Doing Business As Upham's Community Care - Pharmacy.

The provider's business location address is:

415 COLUMBIA RD
DORCHESTER, MA
ZIP 02125-424
Phone: (617) 265-1310
Fax: (617) 265-1654

The provider's authorized official is Jagdeep Trivedi .
The authorized official title is Ceo and has the following contact phone number (617) 287-8000.

The CLIA number assigned to this NPI record is 22D2009168 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2010 and was last updated on 6/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0002XPharmacyClinic PharmacyMA0058176MASSACHUSETTSNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1110024263GMEDICAIDMASSACHUSETTS
22123348OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.