Active NPI
Derek James Quinn, PHARM.D., R.PH.
- Pharmacist
- Portage, MI
National Provider Identifier
1609825173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302034568
- Practice address
- 8822 Portage Rd
Westlake Drug, Inc.
Portage, MI 49002-6416 - Phone
- (269) 327-3049
- Fax
- (269) 327-5817
- NPI assigned
- May 10, 2006
- 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 | 5302034568 | MI | Primary |
Addresses
Primary practice location
8822 Portage Rd
Westlake Drug, Inc.
Portage, MI 49002-6416
Mailing address
8822 Portage Road
Westlake Drug, Inc.
Portage, MI 49002
Phone (269) 327-3049
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302034568 | Other | MI | STATE PHARMACY/CONTROLLED |
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302034568 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1609825173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8822 PORTAGE ROAD",
"address_2": "WESTLAKE DRUG, INC.",
"city": "PORTAGE",
"state": "MI",
"postal_code": "49002",
"telephone_number": "269-327-3049",
"fax_number": "269-327-5817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8822 PORTAGE RD",
"address_2": "WESTLAKE DRUG, INC.",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490026416",
"telephone_number": "269-327-3049",
"fax_number": "269-327-5817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "DEREK",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PHARM.D., R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302034568",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACY/CONTROLLED",
"identifier": "5302034568",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.