Active NPI
Greg Wollman
- Pharmacist
- Worthington, MN
National Provider Identifier
1740607779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 121227
- Practice address
- 1755 N Humiston Ave
Worthington, MN 56187-1757 - Phone
- (507) 376-9309
- Fax
- (507) 372-7840
- NPI assigned
- Mar 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 121227 | MN | Primary |
Addresses
Primary practice location
1755 N Humiston Ave
Worthington, MN 56187-1757
Mailing address
1755 N Humiston Ave
Worthington, MN 56187-1757
Phone (507) 376-9309
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121227 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1740607779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1755 N HUMISTON AVE",
"city": "WORTHINGTON",
"state": "MN",
"postal_code": "561871757",
"telephone_number": "507-376-9309",
"fax_number": "507-372-7840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 N HUMISTON AVE",
"city": "WORTHINGTON",
"state": "MN",
"postal_code": "561871757",
"telephone_number": "507-376-9309",
"fax_number": "507-372-7840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLLMAN",
"first_name": "GREG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-27",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "121227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worthington, MN
- Erika Warren, LICSW
- Ashley Wertish
- Tami Yvonne Wesselink, LICSW
- Abigail Wilking, ATC
- Ryan Willems, PA
- Worthington Anesthesia Services, Inc.
- Worthington Chiropractic Clinic PA
- Worthington Family Dental
- Woven Counseling & Consultation Services, LLC
- WTGN Pharmacy Services LTD (Guidepoint Pharmacy #104)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.