Active NPI
Albert Long
- Pharmacist
- East Saint Louis, IL
National Provider Identifier
1033482807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051286004
- Practice address
- 2510 State St
East Saint Louis, IL 62205-2323 - Phone
- (618) 875-5085
- NPI assigned
- Feb 9, 2012
- Last updated
- Feb 9, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051286004 | IL | Primary |
| Pharmacist | 183500000X | 044511 | MO |
Addresses
Primary practice location
2510 State St
East Saint Louis, IL 62205-2323
Mailing address
5545 Rosemont Ave
East Saint Louis, IL 62204-2919
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051286004 | IL | MD | Pharmacist |
| 044511 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1033482807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5545 ROSEMONT AVE",
"city": "EAST SAINT LOUIS",
"state": "IL",
"postal_code": "622042919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 STATE ST",
"city": "EAST SAINT LOUIS",
"state": "IL",
"postal_code": "622052323",
"telephone_number": "618-875-5085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "ALBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-09",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051286004",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "044511",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Saint Louis, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.