Active NPI
Kevin Robert Bruin, RPH PHARMD
- Pharmacist
- Lima, OH
National Provider Identifier
1699096008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03328613
- Practice address
- 302 W Robb Ave
Lima, OH 45801-2745 - Phone
- (419) 229-5846
- NPI assigned
- Jun 20, 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 | 03328613 | OH | Primary |
Addresses
Primary practice location
302 W Robb Ave
Lima, OH 45801-2745
Mailing address
1922 Jared PL
Lima, OH 45805-1153
Phone (419) 371-6874
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03328613 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane Drug Co | Past | Accepting new patients | |
| Lane Drug Co | Past | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Findlay, OH
- NPI 1184630493
-
- Community/Retail Pharmacy
- Lima, OH
- NPI 1912018003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276992000000",
"number": "1699096008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1922 JARED PL",
"city": "LIMA",
"state": "OH",
"postal_code": "458051153",
"telephone_number": "419-371-6874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 W ROBB AVE",
"city": "LIMA",
"state": "OH",
"postal_code": "458012745",
"telephone_number": "419-229-5846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUIN",
"first_name": "KEVIN",
"middle_name": "ROBERT",
"credential": "RPH PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-20",
"last_updated": "2010-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03328613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.