Active NPI
Michael L Brundage, PHARM.D.
- Pharmacist
- Waymart, PA
National Provider Identifier
1639173032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP-045865-L
- Practice address
- 238 Belmont Street
Waymart, PA 18472-0398 - Phone
- (570) 488-7979
- Fax
- (570) 488-7773
- NPI assigned
- Jun 13, 2005
- Last updated
- Jan 26, 2010
- Sex
- Male
- Sole proprietor
- No
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 | RP-045865-L | PA | Primary |
Addresses
Primary practice location
238 Belmont Street
Waymart, PA 18472-0398
Mailing address
8 Gillette Dr
Waymart, PA 18472-9214
Phone (570) 937-9361
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP-045865-L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brundages Waymart Pharmacy | Current | Accepting new patients | |
| Brundage Pharmacies Inc. | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Waymart, PA
- NPI 1083655765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264464000000",
"number": "1639173032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 GILLETTE DR",
"city": "WAYMART",
"state": "PA",
"postal_code": "184729214",
"telephone_number": "570-937-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 BELMONT STREET",
"city": "WAYMART",
"state": "PA",
"postal_code": "184720398",
"telephone_number": "570-488-7979",
"fax_number": "570-488-7773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNDAGE",
"first_name": "MICHAEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2010-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP-045865-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waymart, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.