Individual provider Active NPI

Lisa Bujak, PHARMD

  • Pharmacist
  • Port Huron, MI
National Provider Identifier
1780054882
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302036388 Issued in MI
Practice address
2601 Electric Ave
Port Huron, MI 48060-6587
Phone
(810) 216-3140
Fax
(810) 216-3145
NPI assigned
Oct 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302036388 MI Primary

Addresses

Primary practice location

2601 Electric Ave
Port Huron, MI 48060-6587

Mailing address

2601 Electric Ave
Port Huron, MI 48060-6587
Phone (810) 216-3140

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

LicenseStateTypeSpecialty
5302036388MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1780054882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606587",
            "telephone_number": "810-216-3140",
            "fax_number": "810-216-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606587",
            "telephone_number": "810-216-3140",
            "fax_number": "810-216-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUJAK",
        "first_name": "LISA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302036388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.