Active NPI
Johannes Dawid Van Der Merwe, R.PH.
- Pharmacist
- Old Town, ME
National Provider Identifier
1487968285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR5830
- Practice address
- 302 Main St
Old Town, ME 04468-1535 - Phone
- (207) 827-8021
- Fax
- (207) 827-3829
- NPI assigned
- Aug 4, 2010
- 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 | PR5830 | ME | Primary |
Addresses
Primary practice location
302 Main St
Old Town, ME 04468-1535
Mailing address
208 Broadway
Apt 2a
Bangor, ME 04401-5210
Phone (207) 385-5735
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 |
|---|---|---|---|
| PR5830 | ME | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1487968285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 BROADWAY",
"address_2": "APT 2A",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015210",
"telephone_number": "207-385-5735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 MAIN ST",
"city": "OLD TOWN",
"state": "ME",
"postal_code": "044681535",
"telephone_number": "207-827-8021",
"fax_number": "207-827-3829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DER MERWE",
"first_name": "JOHANNES",
"middle_name": "DAWID",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-04",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR5830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Town, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.