Bruce J Dovin

Primary specialty

PharmacistTaxonomy code 183500000X

License

044126 Issued in MO

Practice address

110 S Oak St
Advance, MO 63730-8343

Phone

(573) 722-3562

NPI assigned

Nov 24, 2020

Last updated

Nov 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bsap LLC

  dba Advance Pharmacy

  • Community/Retail Pharmacy
  • Advance, MO
  • NPI 1033150891
  NPD Authorized official

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": "1255935938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S OAK ST",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "637308343",
            "telephone_number": "573-722-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S OAK ST",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "637308343",
            "telephone_number": "573-722-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVIN",
        "first_name": "BRUCE",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "044126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601827405",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "advpharm@att.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "110 S Oak St",
            "city": "Advance",
            "state": "MO",
            "country_code": "US",
            "postal_code": "637308343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol S. Coffee, RN
• Jodi Crader
• Cross Trails Medical Center
• Cross Trails Medical Center
• Beverly Jaye Dillow, RDH
• Sarah Dovin, RPH
• Suzana Gjino
• John Carl Graf III, D.M.D.
• Lana S Green, RDH
• Haven Health Care Medical Clinic, Inc

• Pharmacist in Advance, MO
• Providers in Advance, MO by specialty
• Pharmacist in Missouri

• 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.