Active NPI
Cassandra L Granberry
- Pharmacist
- Riviera Beach, FL
National Provider Identifier
1639452147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS30578
- Practice address
- 1920 W Blue Heron Blvd
Riviera Beach, FL 33404-5150 - Phone
- (561) 842-4599
- NPI assigned
- Sep 21, 2011
- Sex
- Female
- 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 | PS30578 | FL | Primary |
Addresses
Primary practice location
1920 W Blue Heron Blvd
Riviera Beach, FL 33404-5150
Mailing address
1920 W Blue Heron Blvd
Riviera Beach, FL 33404-5150
Phone (561) 842-4599
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS30578 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1639452147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 W BLUE HERON BLVD",
"city": "RIVIERA BEACH",
"state": "FL",
"postal_code": "334045150",
"telephone_number": "561-842-4599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 W BLUE HERON BLVD",
"city": "RIVIERA BEACH",
"state": "FL",
"postal_code": "334045150",
"telephone_number": "561-842-4599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANBERRY",
"first_name": "CASSANDRA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS30578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riviera Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.