Individual provider Active NPI

Russell Leslie Tamasco

  • Pharmacist
  • Mobile, AL
National Provider Identifier
1083210405
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9545 Issued in AL
Practice address
CVS #1814
3932 Cottage Hill Rd
Mobile, AL 36695
Phone
(251) 661-1190
NPI assigned
Dec 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 9545 AL Primary

Addresses

Primary practice location

CVS #1814
3932 Cottage Hill Rd
Mobile, AL 36695

Mailing address

CVS #1814
3932 Cottage Hill Rd
Mobile, AL 36695
Phone (251) 661-1190

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MOBILE Direct

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

LicenseStateTypeSpecialty
9545ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1083210405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CVS #1814",
            "address_2": "3932 COTTAGE HILL RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36695",
            "telephone_number": "251-661-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CVS #1814",
            "address_2": "3932 COTTAGE HILL RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36695",
            "telephone_number": "251-661-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMASCO",
        "first_name": "RUSSELL",
        "middle_name": "LESLIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "9545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MOBILE",
            "affiliation": "N",
            "endpointDescription": "phone number",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "CVS #1814",
            "address_2": "3932 Cottage Hill Rd",
            "city": "MOBILE",
            "state": "AL",
            "country_code": "US",
            "postal_code": "36695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.