Active NPI
Charles Robert Diffenderfer, PHARMACIST
- Pharmacist
- Gainesville, FL
National Provider Identifier
1750628640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS32915
- Practice address
- 3930 SW Archer Rd
Gainesville, FL 32608-2342 - Phone
- (352) 367-3342
- Fax
- (352) 367-9408
- NPI assigned
- Jan 11, 2013
- 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 | PS32915 | FL | Primary |
Addresses
Primary practice location
3930 SW Archer Rd
Gainesville, FL 32608-2342
Mailing address
3930 SW Archer Rd
Gainesville, FL 32608-2342
Phone (352) 367-3342
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 |
|---|---|---|---|
| PS32915 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357862400000",
"number": "1750628640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3930 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326082342",
"telephone_number": "352-367-3342",
"fax_number": "352-367-9408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326082342",
"telephone_number": "352-367-3342",
"fax_number": "352-367-9408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFFENDERFER",
"first_name": "CHARLES",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-11",
"last_updated": "2013-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS32915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.