Active NPI
Sean Gogolin, R.PH.
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1306386826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302028325
- Practice address
- 4575 44TH St SE
Suite a
Grand Rapids, MI 49512-4080 - Phone
- (866) 618-5695
- NPI assigned
- Mar 2, 2017
- Last updated
- Mar 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 5302028325 | MI | Primary |
Addresses
Primary practice location
4575 44TH St SE
Suite a
Grand Rapids, MI 49512-4080
Mailing address
7492 Jericho Ave NE
Rockford, MI 49341-8697
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302028325 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmerica Drug Systems LLC | Past | Accepting new patients | |
| Pharmerica Drug Systems LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488412800000",
"number": "1306386826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7492 JERICHO AVE NE",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "493418697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4575 44TH ST SE",
"address_2": "SUITE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495124080",
"telephone_number": "866-618-5695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOGOLIN",
"first_name": "SEAN",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-02",
"last_updated": "2017-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302028325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.