Individual provider Active NPI

Gregory Lopez Ojeda, RPH

  • Pharmacist
  • Vestal, NY
National Provider Identifier
1710209549
Registry record updated Mar 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
045657 Issued in NY
Practice address
2441 Vestal Pkwy E
Sams Club Pharmacy
Vestal, NY 13850-2018
Phone
(607) 797-1370
NPI assigned
Feb 21, 2010
Last updated
Mar 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP045696R PA
Pharmacist 183500000X 045657 NY Primary

Addresses

Primary practice location

2441 Vestal Pkwy E
Sams Club Pharmacy
Vestal, NY 13850-2018

Mailing address

3404 W Stan Schlueter Loop
Killeen, TX 76549-4705
Phone (254) 669-6169

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

LicenseStateTypeSpecialty
RP045696RPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1266710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743292800000",
    "number": "1710209549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 W STAN SCHLUETER LOOP",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494705",
            "telephone_number": "254-669-6169",
            "fax_number": "254-669-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 VESTAL PKWY E",
            "address_2": "SAMS CLUB PHARMACY",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502018",
            "telephone_number": "607-797-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ OJEDA",
        "first_name": "GREGORY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-21",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP045696R",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "045657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2025; 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.