Active NPI
Bruce Allen Stout, RPH
- Pharmacist
- Savanna, IL
National Provider Identifier
1659433381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- Practice address
- 217 Chicago Ave
Savanna, IL 61074-1917 - Phone
- (815) 273-2713
- NPI assigned
- Dec 16, 2006
- Last updated
- Jul 8, 2007
- 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 | IL | Primary |
Addresses
Primary practice location
217 Chicago Ave
Savanna, IL 61074-1917
Mailing address
13135 Messmer Rd
Savanna, IL 61074-8565
Phone (815) 273-4344
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051-035529 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartig Drug Co Corp | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659433381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13135 MESSMER RD",
"city": "SAVANNA",
"state": "IL",
"postal_code": "610748565",
"telephone_number": "815-273-4344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 CHICAGO AVE",
"city": "SAVANNA",
"state": "IL",
"postal_code": "610741917",
"telephone_number": "815-273-2713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "BRUCE",
"middle_name": "ALLEN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savanna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.