Active NPI
Opal Ann Mack, PHARMD
- Pharmacist
- Casper, WY
National Provider Identifier
1336580091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3650
- Practice address
- 300 SE Wyoming Blvd
Casper, WY 82609-4201 - Phone
- (307) 577-7062
- NPI assigned
- Jul 10, 2013
- Last updated
- Mar 28, 2019
- Sex
- Female
- 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 | 3650 | WY | Primary |
Addresses
Primary practice location
300 SE Wyoming Blvd
Casper, WY 82609-4201
Mailing address
190 SE Wyoming Blvd
Casper, WY 82609-1906
Phone (307) 234-9184
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3650 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1373414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553731200000",
"number": "1336580091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 SE WYOMING BLVD",
"city": "CASPER",
"state": "WY",
"postal_code": "826091906",
"telephone_number": "307-234-9184",
"fax_number": "307-234-4685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SE WYOMING BLVD",
"city": "CASPER",
"state": "WY",
"postal_code": "826094201",
"telephone_number": "307-577-7062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "OPAL",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-10",
"last_updated": "2019-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.