Bryan Victor Homberg, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302413648 Issued in MI

Practice address

1048 N McEwan St
Clare, MI 48617-1154

Phone

(989) 386-2900

NPI assigned

Aug 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

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.

• Gateway Pharmacy of Clare Inc

  dba Gateway Pharmacy of Clare

  • Community/Retail Pharmacy
  • Clare, MI
  • NPI 1629066204
  NPD (past)
• Gateway Pharmacy of Clare, Inc.

  • Long Term Care Pharmacy
  • Clare, MI
  • NPI 1497312193
  NPD (past)

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1336814854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171154",
            "telephone_number": "989-386-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171154",
            "telephone_number": "989-386-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMBERG",
        "first_name": "BRYAN",
        "middle_name": "VICTOR",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GatewayPharmacy",
            "affiliation": "N",
            "address_1": "1048 N McEwan St",
            "city": "Clare",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486171154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Hebert
• Kristin Heintz, DC
• Jesus Hernandez Jr., M.D.
• Rene Hernandez, PA
• Calli Cadieu Hoffman, PA-C
• Hannah Kay Horan, PA
• Eric William Houk, CRNA
• Maria Hovey, PA-C
• Patrick L Howe, DPT
• HPMG of Michigan, P.C. (Nurse Practitioners)

• Pharmacist in Clare, MI
• Providers in Clare, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.