Active NPI
Gerardo Garcia
- Pharmacist
- San Luis, AZ
National Provider Identifier
1134542921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S020131
- Practice address
- 1613 N Main St
San Luis, AZ 85349 - Phone
- (928) 722-7288
- Fax
- (928) 722-7288
- NPI assigned
- Jan 29, 2014
- Last updated
- Jan 29, 2014
- 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 | S020131 | AZ | Primary |
Addresses
Primary practice location
1613 N Main St
San Luis, AZ 85349
Mailing address
1613 N Main St
San Luis, AZ 85349
Phone (928) 722-7288
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
| License | State | Type | Specialty |
|---|---|---|---|
| S020131 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | 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.
-
- Community/Retail Pharmacy
- San Luis, AZ
- NPI 1952583692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390953600000",
"number": "1134542921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 N MAIN ST",
"city": "SAN LUIS",
"state": "AZ",
"postal_code": "85349",
"telephone_number": "928-722-7288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1613 N MAIN ST",
"city": "SAN LUIS",
"state": "AZ",
"postal_code": "85349",
"telephone_number": "928-722-7288",
"fax_number": "928-722-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "GERARDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-29",
"last_updated": "2014-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S020131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.