Gavin Charles Lange, PHARMACY TECHNICIAN

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

License

T27627 Issued in MD

Practice address

6701 Harford Rd
Parkville, MD 21234-7721

Phone

(410) 254-2055

NPI assigned

Jan 30, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1710693163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212347787",
            "telephone_number": "410-254-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212347721",
            "telephone_number": "410-254-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "GAVIN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "MD",
            "license": "T27627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD10272062356",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Technician/Technologist in Parkville, MD
• Providers in Parkville, MD by specialty
• Technician/Technologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.