Active NPI
Ted Kuriakose Tomichen, PHARMD
- Pharmacist
- Greenville, MI
National Provider Identifier
1770082968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302042401
- Practice address
- 10772 W Carson City Rd
Greenville, MI 48838-9141 - Phone
- (616) 754-5203
- NPI assigned
- Feb 2, 2018
- Last updated
- Feb 2, 2018
- 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 | 5302042401 | MI | Primary |
Addresses
Primary practice location
10772 W Carson City Rd
Greenville, MI 48838-9141
Mailing address
10772 W Carson City Rd
Greenville, MI 48838-9141
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302042401 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517529600000",
"number": "1770082968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10772 W CARSON CITY RD",
"city": "GREENVILLE",
"state": "MI",
"postal_code": "488389141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10772 W CARSON CITY RD",
"city": "GREENVILLE",
"state": "MI",
"postal_code": "488389141",
"telephone_number": "616-754-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMICHEN",
"first_name": "TED",
"middle_name": "KURIAKOSE",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-02",
"last_updated": "2018-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302042401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.