Active NPI
Subir Mann
- Pharmacist
- Cape Girardeau, MO
National Provider Identifier
1043816994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2020024276
- Practice address
- 202 Siemers Dr Apt 206
Cape Girardeau, MO 63701-8419 - Phone
- (573) 334-6578
- NPI assigned
- Dec 7, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2020024276 | MO | Primary |
Addresses
Primary practice location
202 Siemers Dr Apt 206
Cape Girardeau, MO 63701-8419
Mailing address
CVS Target
202 Siemers Dr
Cape Girardeau, MO 63701
Phone (573) 334-6578
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 |
|---|---|---|---|
| 2020024276 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| Missouri CVS Pharmacy LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1043816994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CVS TARGET",
"address_2": "202 SIEMERS DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "63701",
"telephone_number": "573-334-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 SIEMERS DR APT 206",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637018419",
"telephone_number": "573-334-6578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "SUBIR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2020024276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.