Charles R Spicola, RPH

Key facts

NPI

1750300232

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

044240 (NY)

Practice address

845 Main Rd
Irving, NY 14081-9706

Phone

(716) 951-7000

Fax

(716) 951-7185

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750300232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10765 ROCKY MOUNTAIN RD",
            "city": "NORTH COLLINS",
            "state": "NY",
            "postal_code": "141119619",
            "telephone_number": "716-337-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 MAIN RD",
            "city": "IRVING",
            "state": "NY",
            "postal_code": "140819706",
            "telephone_number": "716-951-7000",
            "fax_number": "716-951-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICOLA",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "044240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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