Individual provider Active NPI

Raeann Mirowski, RPH

  • Pharmacist
  • Williamsville, NY
National Provider Identifier
1205014115
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
050456-1 Issued in NY
Practice address
5275 Sheridan Dr
Attn: Pharmacy Manager
Williamsville, NY 14221-3502
Phone
(716) 633-1781
Fax
(716) 633-0039
NPI assigned
Feb 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 050456-1 NY Primary

Addresses

Primary practice location

5275 Sheridan Dr
Attn: Pharmacy Manager
Williamsville, NY 14221-3502

Mailing address

1500 Brooks Ave
Attn: Pharmacy Office
Rochester, NY 14624-3512
Phone (585) 239-2020

Other identifiers 1

IdentifierTypeStateIssuer
050456-1OtherNYPHARMACIST LICENSE

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
050456-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wegmans Food Markets, Inc. Past Accepting new patients
Wegmans Food Markets, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1205014115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BROOKS AVE",
            "address_2": "ATTN: PHARMACY OFFICE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243512",
            "telephone_number": "585-239-2020",
            "fax_number": "585-239-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 SHERIDAN DR",
            "address_2": "ATTN: PHARMACY MANAGER",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213502",
            "telephone_number": "716-633-1781",
            "fax_number": "716-633-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROWSKI",
        "first_name": "RAEANN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050456-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "050456-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.