Active NPI
Thomas Arnold Gaylord, R.PH.
- Pharmacist
- Grand Marais, MN
National Provider Identifier
1205081908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 110766
- Practice address
- 1036 Devil Track Road
Grand Marais, MN 55604-0190 - Phone
- (218) 387-1283
- NPI assigned
- Nov 21, 2008
- 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 | 110766 | MN | Primary |
Addresses
Primary practice location
1036 Devil Track Road
Grand Marais, MN 55604-0190
Mailing address
PO Box 190
Grand Marais, MN 55604-0190
Phone (218) 387-1283
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 |
|---|---|---|---|
| 110766 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227225600000",
"number": "1205081908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556040190",
"telephone_number": "218-387-1283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 DEVIL TRACK ROAD",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556040190",
"telephone_number": "218-387-1283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYLORD",
"first_name": "THOMAS",
"middle_name": "ARNOLD",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-21",
"last_updated": "2008-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "110766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Marais, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.