Individual provider Active NPI

Alicia Trail, RPH

  • Pharmacotherapy Pharmacist
  • Hartland, MI
National Provider Identifier
1790195451
Registry record updated May 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
5302411106 Issued in MI
Practice address
2160 Hartland Rd
Hartland, MI 48353-2502
Phone
(810) 632-4210
Fax
(810) 632-4265
NPI assigned
May 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 5302411106 MI Primary

Addresses

Primary practice location

2160 Hartland Rd
Hartland, MI 48353-2502

Mailing address

2160 Hartland Rd
Hartland, MI 48353-2502
Phone (810) 632-4210

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

LicenseStateTypeSpecialty
5302411106MIMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Meijer Inc Past Accepting new patients
Meijer Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399161600000",
    "number": "1790195451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 HARTLAND RD",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483532502",
            "telephone_number": "810-632-4210",
            "fax_number": "810-632-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 HARTLAND RD",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483532502",
            "telephone_number": "810-632-4210",
            "fax_number": "810-632-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAIL",
        "first_name": "ALICIA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-04",
        "last_updated": "2014-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MI",
            "license": "5302411106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2014; 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.