Active NPI
Robert S Fleece, R.PH
- Pharmacist
- Grand Blanc, MI
National Provider Identifier
1083742910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302021010
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302021010 | MI | MD | Pharmacist |
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.