Active NPI
Gerald Matthew Mandrell, RPH
- Pharmacist
- Tallahassee, FL
National Provider Identifier
1447715628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS18142
- Practice address
- 1950 Commonwealth LN
Tallahassee, FL 32303-3196 - Phone
- (850) 504-6262
- NPI assigned
- Feb 1, 2019
- Last updated
- Feb 1, 2019
- 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 | PS18142 | FL | Primary |
Addresses
Primary practice location
1950 Commonwealth LN
Tallahassee, FL 32303-3196
Mailing address
1911 Chowkeebin CT
Tallahassee, FL 32301-5870
Phone (850) 322-5313
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS18142 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmacy Corporation of America | Past | Accepting new patients | |
| Pharmacy Corporation of America | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Pharmerica
- Long Term Care Pharmacy
- Tallahassee, FL
- NPI 1013940683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1447715628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 CHOWKEEBIN CT",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323015870",
"telephone_number": "850-322-5313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 COMMONWEALTH LN",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323033196",
"telephone_number": "850-504-6262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDRELL",
"first_name": "GERALD",
"middle_name": "MATTHEW",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS18142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.