Individual provider Active NPI

Michael Cansino Chua, PHARM.D.

  • Pharmacist
  • Harrisville, WV
National Provider Identifier
1114226909
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
057281 Issued in NY
Practice address
RR 2 Box 1Aa
1490 East Main St
Harrisville, WV 26362-9602
Phone
(304) 643-2902
Fax
(304) 643-2834
NPI assigned
Mar 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP007426 WV
Pharmacist 183500000X 28RI03327300 NJ
Pharmacist 183500000X 057281 NY Primary

Addresses

Primary practice location

RR 2 Box 1Aa
1490 East Main St
Harrisville, WV 26362-9602

Mailing address

RR 2 Box 1Aa
1490 East Main St
Harrisville, WV 26362-9602
Phone (304) 643-2902

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
057281NYMDDentist
28RI03327300NJMDPharmacist
RP007426WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1114226909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 1AA",
            "address_2": "1490 EAST MAIN ST",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263629602",
            "telephone_number": "304-643-2902",
            "fax_number": "304-643-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 1AA",
            "address_2": "1490 EAST MAIN ST",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263629602",
            "telephone_number": "304-643-2902",
            "fax_number": "304-643-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "MICHAEL",
        "middle_name": "CANSINO",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP007426",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03327300",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "057281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.