Individual provider Active NPI

Maggie Mangino, PHARMD

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1285866269
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
014123 Issued in KY
Practice address
530 S Jackson St
Louisville, KY 40202-1675
Phone
(502) 562-4415
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 014123 KY Primary

Addresses

Primary practice location

530 S Jackson St
Louisville, KY 40202-1675

Mailing address

2100 Gardiner LN
Sullivan University College of Pharmacy
Louisville, KY 40205-2962
Phone (502) 609-0937

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
014123KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1285866269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 GARDINER LN",
            "address_2": "SULLIVAN UNIVERSITY COLLEGE OF PHARMACY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052962",
            "telephone_number": "502-609-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-562-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGINO",
        "first_name": "MAGGIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "014123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.