Unknown Individual – Pharmacist, NPI 1104874023

Unknown Individual is a healthcare provider. based in Bedford, Massachusetts. specializing in Pharmacist. They hold a License No. 18162 (MA). The NPI Number for Unknown Individual is 1104874023

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104874023
Phone
(781) 687-2965
Address
200 SPRINGS RD
Deactivation Date
5 June 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Edith Nourse Rogers Memorial Veterans Hospital, 200, Springs Road, Bedford, Middlesex County, Massachusetts, 01730, United States

    #119

    BEDFORD, MA 017301114

    Phone: (781) 687-2965

    Type: Location

  • 363, Wentworth Avenue, Oaklands, Lowell, Middlesex County, Massachusetts, 08152, United States

    LOWELL, MA 018523820

    Phone: (781) 687-2965

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01730)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1104874023 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Pharmacist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Bedford, Massachusetts for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1104874023. Always confirm identity and privileges with the practice and licensing boards.

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