Active NPI
Gary Lane Cunningham, R.PH.
- Pharmacist
- Gilbert, WV
National Provider Identifier
1104042381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0005150
- Practice address
- 22 Larry Joe Harless Dr.
Gilbert, WV 25621 - Phone
- (304) 664-3343
- NPI assigned
- Apr 17, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0005150 | WV | Primary |
Addresses
Primary practice location
22 Larry Joe Harless Dr.
Gilbert, WV 25621
Mailing address
PO Box 1562
Oceana, WV 24870-1562
Phone (304) 682-4586
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 |
|---|---|---|---|
| RP0005150 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Pharmacy Inc | Past | Accepting new patients | |
| Riverside Pharmacy 2 LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Riverside Pharmacy 2
- Community/Retail Pharmacy
- Gilbert, WV
- NPI 1831999804
-
- Community/Retail Pharmacy
- Gilbert, WV
- NPI 1720206774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104042381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1562",
"city": "OCEANA",
"state": "WV",
"postal_code": "248701562",
"telephone_number": "304-682-4586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 LARRY JOE HARLESS DR.",
"city": "GILBERT",
"state": "WV",
"postal_code": "25621",
"telephone_number": "304-664-3343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNINGHAM",
"first_name": "GARY",
"middle_name": "LANE",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0005150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, WV
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.