Individual provider Active NPI

Rick Roger Bergquist, RPH

  • Pharmacist
  • Hornell, NY
National Provider Identifier
1619145299
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
035985 Issued in NY
Practice address
1000 Highway 36 North
Attn: Pharmacy Manager
Hornell, NY 14843
Phone
(607) 324-4870
Fax
(607) 324-3313
NPI assigned
Feb 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 035985 NY Primary

Addresses

Primary practice location

1000 Highway 36 North
Attn: Pharmacy Manager
Hornell, NY 14843

Mailing address

1500 Brooks Ave
Attn: Pharmacy Manager
Rochester, NY 14624-3512
Phone (585) 239-2020

Other identifiers 1

IdentifierTypeStateIssuer
035985OtherNYPHARMACIST LICENSE

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
035985NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1619145299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BROOKS AVE",
            "address_2": "ATTN: PHARMACY MANAGER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243512",
            "telephone_number": "585-239-2020",
            "fax_number": "585-239-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 36 NORTH",
            "address_2": "ATTN: PHARMACY MANAGER",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "14843",
            "telephone_number": "607-324-4870",
            "fax_number": "607-324-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGQUIST",
        "first_name": "RICK",
        "middle_name": "ROGER",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "035985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "035985",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hornell, NY

Sources for this page

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

Verify at the official NPI Registry.