Individual provider Active NPI

Paul Charles Villaret, PHARMD

  • Pharmacist
  • Eagle, ID
National Provider Identifier
1437795259
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6336 Issued in ID
Practice address
1855 N Groveland PL
Eagle, ID 83616-4275
Phone
(702) 335-2626
NPI assigned
Nov 27, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6336 ID Primary

Addresses

Primary practice location

1855 N Groveland PL
Eagle, ID 83616-4275

Mailing address

1855 N Groveland PL
Eagle, ID 83616-4275
Phone (702) 335-2626

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
6336IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1437795259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 N GROVELAND PL",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164275",
            "telephone_number": "702-335-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 N GROVELAND PL",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164275",
            "telephone_number": "702-335-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARET",
        "first_name": "PAUL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "6336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.