Active NPI
Alan Pendergrass, PHARM.D., M.B.A.
- Pharmacist
- Hudson, OH
National Provider Identifier
1497919807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03-1-27675
- Practice address
- 1713 McCausland Dr
Hudson, OH 44236-5374 - Phone
- (330) 474-1759
- NPI assigned
- Jul 15, 2008
- 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 | 03-1-27675 | OH | Primary |
Addresses
Primary practice location
1713 McCausland Dr
Hudson, OH 44236-5374
Mailing address
1713 McCausland Dr
Hudson, OH 44236-5374
Phone (330) 474-1759
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
- Master of Business Administration, Doctor of Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1497919807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 MCCAUSLAND DR",
"city": "HUDSON",
"state": "OH",
"postal_code": "442365374",
"telephone_number": "330-474-1759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1713 MCCAUSLAND DR",
"city": "HUDSON",
"state": "OH",
"postal_code": "442365374",
"telephone_number": "330-474-1759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDERGRASS",
"first_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PHARM.D., M.B.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-15",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03-1-27675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.