Active NPI
Alan J Kaczynski, RPH
- Pharmacist
- Essexville, MI
National Provider Identifier
1366727612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302410895
- Practice address
- 2901 Center Ave
Essexville, MI 48732-1703 - Phone
- (989) 894-4832
- NPI assigned
- Oct 19, 2011
- Last updated
- Dec 29, 2022
- 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 | 5302410895 | MI | Primary |
Addresses
Primary practice location
2901 Center Ave
Essexville, MI 48732-1703
Mailing address
2901 Center Ave
Essexville, MI 48732-1703
Phone (989) 894-4832
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 |
|---|---|---|---|
| 5302410895 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2901 Center Ave
Essexville, MI 48732
Phone (989) 894-4832
Organizations & group practices 3
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": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1366727612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 CENTER AVE",
"city": "ESSEXVILLE",
"state": "MI",
"postal_code": "487321703",
"telephone_number": "989-894-4832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 CENTER AVE",
"city": "ESSEXVILLE",
"state": "MI",
"postal_code": "487321703",
"telephone_number": "989-894-4832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACZYNSKI",
"first_name": "ALAN",
"middle_name": "J",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-19",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302410895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essexville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.