Active NPI
Elizabeth Ann Woolsey, PHARMD
- Pharmacist
- South Bend, IN
National Provider Identifier
1063635993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26021547A
- Practice address
- 426 N Michigan St
South Bend, IN 46601-1228 - Phone
- (574) 234-3184
- NPI assigned
- Apr 10, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | 26021547A | IN | Primary |
Addresses
Primary practice location
426 N Michigan St
South Bend, IN 46601-1228
Mailing address
2200 Hoveland Ave
Long Beach, IN 46360-1521
Phone (219) 879-1640
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26021547A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mar-Main Pharmacy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- South Bend, IN
- NPI 1649277369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063635993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 HOVELAND AVE",
"city": "LONG BEACH",
"state": "IN",
"postal_code": "463601521",
"telephone_number": "219-879-1640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 N MICHIGAN ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011228",
"telephone_number": "574-234-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLSEY",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26021547A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.