Active NPI
Elias Wassie Nuru, RPH
- Pharmacist
- Willits, CA
National Provider Identifier
1346580966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68484
- Practice address
- 845 S Main St
Willits, CA 95490-3915 - Phone
- (707) 459-5862
- NPI assigned
- Feb 19, 2013
- 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 | 68484 | CA | Primary |
Addresses
Primary practice location
845 S Main St
Willits, CA 95490-3915
Mailing address
79 Bush St
#4
Willits, CA 95490-3878
Phone (408) 482-5562
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 |
|---|---|---|---|
| 68484 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361232000000",
"number": "1346580966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 BUSH ST",
"address_2": "#4",
"city": "WILLITS",
"state": "CA",
"postal_code": "954903878",
"telephone_number": "408-482-5562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 S MAIN ST",
"city": "WILLITS",
"state": "CA",
"postal_code": "954903915",
"telephone_number": "707-459-5862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NURU",
"first_name": "ELIAS",
"middle_name": "WASSIE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-19",
"last_updated": "2013-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willits, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.