1124744214 NPI number — DR. AIMEE O'CONNELL PHARMD

Table of content: DR. AIMEE O'CONNELL PHARMD (NPI 1124744214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124744214 NPI number — DR. AIMEE O'CONNELL PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'CONNELL
Provider First Name:
AIMEE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MERTZ
Provider Other First Name:
AIMEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124744214
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 189
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01842-0389
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-683-4000
Provider Business Mailing Address Fax Number:
978-946-8356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GENERAL STREET
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PHARMACY
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-683-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835C0205X , with the licence number:  PH27575 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P0018X , with the licence number: PH27575 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PH27575 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)