Active NPI
Steven F Gorman-Hackstadt, RPH
- Pharmacist
- Show Low, AZ
National Provider Identifier
1770898660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 007832
- Practice address
- 5160 S White Mountain Rd
Show Low, AZ 85901-7826 - Phone
- (928) 532-5502
- Fax
- (928) 532-5499
- NPI assigned
- Aug 16, 2010
- Last updated
- Aug 16, 2010
- 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 | 007832 | AZ | Primary |
Addresses
Primary practice location
5160 S White Mountain Rd
Show Low, AZ 85901-7826
Mailing address
1541 N Blue Grass Ranch Dr
Lakeside, AZ 85929-9776
Phone (928) 367-6177
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007832 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281916800000",
"number": "1770898660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1541 N BLUE GRASS RANCH DR",
"city": "LAKESIDE",
"state": "AZ",
"postal_code": "859299776",
"telephone_number": "928-367-6177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5160 S WHITE MOUNTAIN RD",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859017826",
"telephone_number": "928-532-5502",
"fax_number": "928-532-5499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN-HACKSTADT",
"first_name": "STEVEN",
"middle_name": "F",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-16",
"last_updated": "2010-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "007832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.