Individual provider Active NPI

Thurmon Jay Gauldin Jr.

  • Pharmacist
  • Hanover, PA
National Provider Identifier
1215531900
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP045350R Issued in PA
Practice address
635 Carlisle St
Hanover, PA 17331-5102
Phone
(717) 637-5228
Fax
(717) 637-2573
NPI assigned
Nov 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPI004975 PA
Pharmacist 183500000X RP045350R PA Primary

Addresses

Primary practice location

635 Carlisle St
Hanover, PA 17331-5102

Mailing address

635 Carlisle St
Hanover, PA 17331-5102
Phone (717) 637-5228

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

LicenseStateTypeSpecialty
RP045350RPAMDPharmacist
RPI004975PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1215531900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 CARLISLE ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315102",
            "telephone_number": "717-637-5228",
            "fax_number": "717-637-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 CARLISLE ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315102",
            "telephone_number": "717-637-5228",
            "fax_number": "717-637-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULDIN",
        "first_name": "THURMON",
        "middle_name": "JAY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RPI004975",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP045350R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.