Active NPI
Lawrence Stack, B.S., R.PH.
- Pharmacist
- Ocean, NJ
National Provider Identifier
1063977320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI01888200
- Practice address
- 25 Provident CT
Ocean, NJ 07712-7266 - Phone
- (732) 915-2999
- Fax
- (732) 230-6615
- NPI assigned
- Jan 31, 2019
- Last updated
- Jan 31, 2019
- 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 | 28RI01888200 | NJ | Primary |
| Pharmacist | 183500000X | 10576 | MD |
Addresses
Primary practice location
25 Provident CT
Ocean, NJ 07712-7266
Mailing address
25 Provident CT
Ocean, NJ 07712-7266
Phone (732) 915-2999
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
- Bachelor of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10576 | MD | MD | Pharmacist |
| 28RI01888200 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1063977320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 PROVIDENT CT",
"city": "OCEAN",
"state": "NJ",
"postal_code": "077127266",
"telephone_number": "732-915-2999",
"fax_number": "732-230-6615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 PROVIDENT CT",
"city": "OCEAN",
"state": "NJ",
"postal_code": "077127266",
"telephone_number": "732-915-2999",
"fax_number": "732-230-6615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACK",
"first_name": "LAWRENCE",
"credential": "B.S., R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-31",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI01888200",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "10576",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean, NJ
- Denise Siwinski, MD
- Laura Susan Sofield II, RN, APN-C
- Sondike Behavioral Connection LLC
- Christopher John Spagnuola, MD
- Michele Alice St. Marie, MSW
- Stages Pediatric Physical Therapy LLC
- Stages Pediatric Physical Therapy LLC
- Robert Stasiak, DPT
- Michael Alan Steinle, D.M.D.
- Denise E Stevens-Jones, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.