Active NPI
Philip C Pole, PHARM.D, R.PH
- Pharmacist
- Roseville, MN
National Provider Identifier
1003102278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 118661
- Practice address
- 1515 County Road B W
T-2101
Roseville, MN 55113-6005 - Phone
- (651) 631-1450
- NPI assigned
- Jun 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 118661 | MN | Primary |
Addresses
Primary practice location
1515 County Road B W
T-2101
Roseville, MN 55113-6005
Mailing address
1515 County Road B W
T-2101
Roseville, MN 55113-6005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118661 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308960000000",
"number": "1003102278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 COUNTY ROAD B W",
"address_2": "T-2101",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551136005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 COUNTY ROAD B W",
"address_2": "T-2101",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551136005",
"telephone_number": "651-631-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLE",
"first_name": "PHILIP",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PHARM.D, R.PH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-25",
"last_updated": "2011-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "118661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.