Active NPI
Jose Roque, PHARMD
- Pharmacist
- West Allis, WI
National Provider Identifier
1477239986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2214240
- Practice address
- 2600 S 108TH St
West Allis, WI 53227-1926 - Phone
- (414) 545-0385
- NPI assigned
- Jun 27, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 2214240 | WI | Primary |
Addresses
Primary practice location
2600 S 108TH St
West Allis, WI 53227-1926
Mailing address
617 S Layton Blvd
Milwaukee, WI 53215-1222
Phone (414) 418-3329
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2214240 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1477239986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 S LAYTON BLVD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532151222",
"telephone_number": "414-418-3329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 S 108TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271926",
"telephone_number": "414-545-0385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUE",
"first_name": "JOSE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-27",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "2214240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.