Individual provider Active NPI

Peter Joseph Mysliwiec III, RPH

  • Pharmacist
  • Moundsville, WV
National Provider Identifier
1528207420
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0004233 Issued in WV
Practice address
120 Jefferson Ave
Moundsville, WV 26041-1411
Phone
(304) 845-4230
NPI assigned
Feb 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0004233 WV Primary

Addresses

Primary practice location

120 Jefferson Ave
Moundsville, WV 26041-1411

Mailing address

120 Jefferson Ave
Moundsville, WV 26041-1411
Phone (304) 845-4230

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
RP0004233WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1528207420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 JEFFERSON AVE",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260411411",
            "telephone_number": "304-845-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 JEFFERSON AVE",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260411411",
            "telephone_number": "304-845-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSLIWIEC",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0004233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moundsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.