Jerome Borth, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

112215 Issued in MN

Practice address

1850 Adams St
Target Store T0663
Mankato, MN 56001-4864

Phone

(507) 625-9009

Fax

(507) 625-9009

NPI assigned

Jun 20, 2011

Last updated

Jun 20, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1609161504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 ADAMS ST",
            "address_2": "TARGET STORE T0663",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014864",
            "telephone_number": "507-625-9009",
            "fax_number": "507-625-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 ADAMS ST",
            "address_2": "TARGET STORE T0663",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014864",
            "telephone_number": "507-625-9009",
            "fax_number": "507-625-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTH",
        "first_name": "JEROME",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "112215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Mankato, MN
• Providers in Mankato, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.