Active NPI
Michael Gengenbacher, PHARMACIST
- Pharmacist
- Chandler, AZ
National Provider Identifier
1306177126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S011495
- Practice address
- 1925 W Chandler Blvd
Chandler, AZ 85224-6149 - Phone
- (480) 963-2705
- NPI assigned
- Jan 18, 2010
- 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 | S011495 | AZ | Primary |
Addresses
Primary practice location
1925 W Chandler Blvd
Chandler, AZ 85224-6149
Mailing address
4704 E Strawberry Dr
Gilbert, AZ 85298-8343
Phone (480) 802-2897
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 |
|---|---|---|---|
| S011495 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263772800000",
"number": "1306177126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4704 E STRAWBERRY DR",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852988343",
"telephone_number": "480-802-2897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 W CHANDLER BLVD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852246149",
"telephone_number": "480-963-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENGENBACHER",
"first_name": "MICHAEL",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-18",
"last_updated": "2010-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S011495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.