Active NPI
Gary D Brown, RPH
- Pharmacist
- Clinton Township, MI
National Provider Identifier
1780295865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302410906
- Practice address
- 1045 S Gratiot Ave
Clinton Township, MI 48036-3501 - Phone
- (586) 954-4905
- Fax
- (586) 954-4938
- NPI assigned
- Aug 12, 2020
- 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 | 5302410906 | MI | Primary |
Addresses
Primary practice location
1045 S Gratiot Ave
Clinton Township, MI 48036-3501
Mailing address
1045 S Gratiot Ave
Clinton Township, MI 48036-3501
Phone (586) 954-4905
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 |
|---|---|---|---|
| 5302410906 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1780295865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 S GRATIOT AVE",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480363501",
"telephone_number": "586-954-4905",
"fax_number": "586-954-4938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 S GRATIOT AVE",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480363501",
"telephone_number": "586-954-4905",
"fax_number": "586-954-4938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "GARY",
"middle_name": "D",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-12",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302410906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.