Active NPI
Charles Edward Rand
- Pharmacist
- Ironwood, MI
National Provider Identifier
1417559592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302038401
- Practice address
- 802 E Cloverland Dr
Ironwood, MI 49938-1502 - Phone
- (906) 932-4267
- Fax
- (906) 932-4609
- NPI assigned
- Nov 12, 2020
- 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 | 5302038401 | MI | Primary |
Addresses
Primary practice location
802 E Cloverland Dr
Ironwood, MI 49938-1502
Mailing address
802 E Cloverland Dr
Ironwood, MI 49938-1502
Phone (906) 932-4267
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038401 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
802 E Cloverland Dr
Ironwood, MI 49938
Phone (906) 932-4267
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1417559592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 E CLOVERLAND DR",
"city": "IRONWOOD",
"state": "MI",
"postal_code": "499381502",
"telephone_number": "906-932-4267",
"fax_number": "906-932-4609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 E CLOVERLAND DR",
"city": "IRONWOOD",
"state": "MI",
"postal_code": "499381502",
"telephone_number": "906-932-4267",
"fax_number": "906-932-4609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAND",
"first_name": "CHARLES",
"middle_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-12",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ironwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.