Individual provider Active NPI

Robert S Fleece, R.PH

  • Pharmacist
  • Grand Blanc, MI
National Provider Identifier
1083742910
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302021010 Issued in MI
Practice address
12724 S Saginaw St
Grand Blanc, MI 48439-1831
Phone
(810) 694-2500
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302021010 MI Primary

Addresses

Primary practice location

12724 S Saginaw St
Grand Blanc, MI 48439-1831

Mailing address

12168 Birchwood LN
Grand Blanc, MI 48439-1642
Phone (810) 695-5419

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302021010MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083742910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12168 BIRCHWOOD LN",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391642",
            "telephone_number": "810-695-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391831",
            "telephone_number": "810-694-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEECE",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302021010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

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.

Verify at the official NPI Registry.