Individual provider Active NPI

Gordon Lange

  • Pharmacist
  • Howell, MI
National Provider Identifier
1649816901
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302025608 Issued in MI
Practice address
10059 E Highland Rd
Howell, MI 48843-1367
Phone
(810) 991-2352
NPI assigned
Nov 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302025608 MI Primary

Addresses

Primary practice location

10059 E Highland Rd
Howell, MI 48843-1367

Mailing address

10059 E Highland Rd
Howell, MI 48843-1367
Phone (810) 991-2352

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

LicenseStateTypeSpecialty
5302025608MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1649816901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10059 E HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431367",
            "telephone_number": "810-991-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10059 E HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431367",
            "telephone_number": "810-991-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "GORDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302025608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.