Kale Dean Hanavan, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

03438823 Issued in OH

Practice address

201 S Main St
New Carlisle, OH 45344-1954

Phone

(937) 845-3848

NPI assigned

Nov 20, 2020

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

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 and National Provider Directory roles.

• Ohio CVS Stores LLC

  • Pharmacy
  • New Carlisle, OH
  • NPI 1649373366
  NPD (past)
• Ohio CVS Stores, L.L.C.

  • Pharmacy
  • Woodmere, OH
  • NPI 1922736305
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1417550484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "NEW CARLISLE",
            "state": "OH",
            "postal_code": "453441954",
            "telephone_number": "937-845-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "NEW CARLISLE",
            "state": "OH",
            "postal_code": "453441954",
            "telephone_number": "937-845-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAVAN",
        "first_name": "KALE",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03438823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rx03457@cvshealth.com",
            "affiliation": "N",
            "endpointDescription": "Secure intranet Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "201 S Main St",
            "city": "New Carlisle",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453441954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacie Grigsby, CNP
• Jennifer Louise Gross, PHARM.D.
• Melissa Ann Gundolf, RN
• Marcus Gutierrez
• Ferrara Hammer
• Amy Jean Hanford
• Angela Hannah
• Jennifer N Hardacre
• Deshawn Antonio Harris Sr., APRN
• Harts Automated Medical Services Inc

• Pharmacist in New Carlisle, OH
• Providers in New Carlisle, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.