Active NPI
Naga M Pachigolla
- Pharmacist
- Burton, MI
National Provider Identifier
1265722904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302035939
- Practice address
- G3009 S Dort Hwy
Burton, MI 48529-1081 - Phone
- (810) 742-8409
- NPI assigned
- Apr 14, 2011
- 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 | 5302035939 | MI | Primary |
Addresses
Primary practice location
G3009 S Dort Hwy
Burton, MI 48529-1081
Mailing address
1297 Heatherwood Dr,Apt 1a
Grand Blanc, MI 48439
Phone (810) 742-8409
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 |
|---|---|---|---|
| 5302035939 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perry Drug Stores Inc and Subsidiaries | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Commerce Township, MI
- NPI 1871602391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1265722904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1297 HEATHERWOOD DR,APT 1A",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "48439",
"telephone_number": "810-742-8409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "G3009 S DORT HWY",
"city": "BURTON",
"state": "MI",
"postal_code": "485291081",
"telephone_number": "810-742-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHIGOLLA",
"first_name": "NAGA",
"middle_name": "M",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-14",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302035939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.