Individual provider Active NPI

Nancy Stack, RPH

  • Pharmacist
  • Herkimer, NY
National Provider Identifier
1033392121
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
029856 Issued in NY
Practice address
103 N Caroline St
Herkimer, NY 13350-1716
Phone
(315) 717-0219
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 029856 NY Primary

Addresses

Primary practice location

103 N Caroline St
Herkimer, NY 13350-1716

Mailing address

7 Dayton PL
Herkimer, NY 13350-1143
Phone (315) 866-6279

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
029856NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1033392121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DAYTON PL",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501143",
            "telephone_number": "315-866-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N CAROLINE ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501716",
            "telephone_number": "315-717-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "NANCY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "029856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herkimer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.