NPIMap

Individual provider Active NPI

Mary Jane Freehauf, R.PH.

  • Pharmacist
  • South Bend, IN
National Provider Identifier
1447544762
Registry record updated Jun 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26018158A Issued in IN
Practice address
1400 E Ireland Rd
T-1902
South Bend, IN 46614-3452
Phone
(574) 231-8258
Fax
(574) 231-8258
NPI assigned
Jun 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26018158A IN Primary

Addresses

Primary practice location

1400 E Ireland Rd
T-1902
South Bend, IN 46614-3452

Mailing address

1400 E Ireland Rd
T-1902
South Bend, IN 46614-3452
Phone (574) 231-8258

Other names 1

  • Ms. Mary Jane Brummel Former name

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

LicenseStateTypeSpecialty
26018158AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1447544762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E IRELAND RD",
            "address_2": "T-1902",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143452",
            "telephone_number": "574-231-8258",
            "fax_number": "574-231-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E IRELAND RD",
            "address_2": "T-1902",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143452",
            "telephone_number": "574-231-8258",
            "fax_number": "574-231-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEHAUF",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26018158A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BRUMMEL",
            "middle_name": "JANE",
            "prefix": "MS.",
            "credential": "R.PH.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2011; 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.