Individual provider Active NPI

Lilian Ijeoma Ogagan

  • Pharmacist
  • Brunswick, ME
National Provider Identifier
1376029405
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR5350 Issued in ME
Practice address
15 Tibbetts Dr
Brunswick, ME 04011-2680
Phone
(207) 725-1176
Fax
(207) 725-1385
NPI assigned
Jul 11, 2018
Last updated
Jul 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH26445 MA
Pharmacist 183500000X PR5350 ME Primary

Addresses

Primary practice location

15 Tibbetts Dr
Brunswick, ME 04011-2680

Mailing address

15 Tibbetts Dr
Brunswick, ME 04011-2680
Phone (207) 725-1176

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

State licenses

LicenseStateTypeSpecialty
PH26445MAMDPharmacist
PR5350MEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1376029405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TIBBETTS DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112680",
            "telephone_number": "207-725-1176",
            "fax_number": "207-725-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TIBBETTS DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112680",
            "telephone_number": "207-725-1176",
            "fax_number": "207-725-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGAGAN",
        "first_name": "LILIAN",
        "middle_name": "IJEOMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH26445",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.