Individual provider Active NPI

Jose Guerrero, PHARMD.

  • Community/Retail Pharmacy
  • Grand Island, NE
National Provider Identifier
1699341933
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
13419 Issued in NE
Practice address
423 W 4TH St
Grand Island, NE 68801-4503
Phone
(308) 384-7372
Fax
(308) 384-6067
NPI assigned
May 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 13419 NE Primary

Addresses

Primary practice location

423 W 4TH St
Grand Island, NE 68801-4503

Mailing address

423 W 4TH St
Grand Island, NE 68801-4503
Phone (308) 384-7372

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

State licenses

LicenseStateTypeSpecialty
13419NEMDCommunity/Retail Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1699341933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 W 4TH ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688014503",
            "telephone_number": "308-384-7372",
            "fax_number": "308-384-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 W 4TH ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688014503",
            "telephone_number": "308-384-7372",
            "fax_number": "308-384-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "JOSE",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "13419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.