Gavrilo Durica, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

S019569 Issued in AZ

Practice address

900 W Deuce of Clubs
Show Low, AZ 85901-6214

Phone

(928) 532-5660

NPI assigned

Nov 20, 2012

Last updated

Nov 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1073857686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S WHT MTN RD APT 622",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017334",
            "telephone_number": "716-951-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W DEUCE OF CLUBS",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859016214",
            "telephone_number": "928-532-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURICA",
        "first_name": "GAVRILO",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ PHARMACIST LICENSE",
            "identifier": "S019569",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ IMMUNIZATION CERTIFICATE",
            "identifier": "3191",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.