Alan D Gray, RPH
Individual provider Active NPI Pharmacist · Wauchula, FL
NPI 1679919161 · NPPES record last updated May 11, 2013
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Aug 20, 2018.
Key facts
- NPI
- 1679919161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS23115 (FL)
- Practice address
- 1510 US Highway 17 N
Wauchula, FL 33873-5002 - Phone
- (863) 767-1062
- Fax
- (863) 773-3789
- NPI assigned
- May 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS23115 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS23115 | FL | Yes |
Addresses
Primary practice location
1510 US Highway 17 N
Wauchula, FL 33873-5002
Mailing address
13308 Hollowbend LN
Riverview, FL 33569-5759
Phone (813) 758-0981
Other providers in Wauchula, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.