Active NPI
Walter Wesley Coolbaugh, RPH
- Pharmacist
- Cato, NY
National Provider Identifier
1700066941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 34463
- Practice address
- 2949 State Route 370
Cato, NY 13033 - Phone
- (315) 626-3161
- NPI assigned
- Nov 5, 2007
- 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 | 34463 | NY | Primary |
Addresses
Primary practice location
2949 State Route 370
Cato, NY 13033
Mailing address
2816 Ross Dr
Weedsport, NY 13166-9764
Phone (315) 834-6038
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 |
|---|---|---|---|
| 34463 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194220800000",
"number": "1700066941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2816 ROSS DR",
"city": "WEEDSPORT",
"state": "NY",
"postal_code": "131669764",
"telephone_number": "315-834-6038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2949 STATE ROUTE 370",
"city": "CATO",
"state": "NY",
"postal_code": "13033",
"telephone_number": "315-626-3161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLBAUGH",
"first_name": "WALTER",
"middle_name": "WESLEY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-05",
"last_updated": "2007-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "34463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cato, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.