Individual provider Active NPI

Bradley Scot Denovchek, RPH

  • Pharmacist
  • Suwanee, GA
National Provider Identifier
1295021780
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH020179 Issued in GA
Practice address
2625 Peachtree Pkwy
T-2056
Suwanee, GA 30024-1048
Phone
(678) 965-5806
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH020179 GA Primary

Addresses

Primary practice location

2625 Peachtree Pkwy
T-2056
Suwanee, GA 30024-1048

Mailing address

2625 Peachtree Pkwy
T-2056
Suwanee, GA 30024-1048
Phone (678) 965-5806

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

LicenseStateTypeSpecialty
RPH020179GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1295021780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 PEACHTREE PKWY",
            "address_2": "T-2056",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241048",
            "telephone_number": "678-965-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 PEACHTREE PKWY",
            "address_2": "T-2056",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241048",
            "telephone_number": "678-965-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENOVCHEK",
        "first_name": "BRADLEY",
        "middle_name": "SCOT",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH020179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.

Verify at the official NPI Registry.