Active NPI
Max Placke, RPH
- Pharmacist
- Mishawaka, IN
National Provider Identifier
1801146170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26017267A
- Practice address
- 5215 Holy Cross Pkwy
Mishawaka, IN 46545 - Phone
- (574) 335-3110
- NPI assigned
- Sep 14, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26017267A | IN | Primary |
| Pharmacist | 183500000X | 5302031609 | MI |
Addresses
Primary practice location
5215 Holy Cross Pkwy
Mishawaka, IN 46545
Mailing address
11365 Harbridge CT.
Granger, IN 46530
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 |
|---|---|---|---|
| 26017267A | IN | MD | Pharmacist |
| 5302031609 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347580800000",
"number": "1801146170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11365 HARBRIDGE CT.",
"city": "GRANGER",
"state": "IN",
"postal_code": "46530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5215 HOLY CROSS PKWY",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "46545",
"telephone_number": "574-335-3110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLACKE",
"first_name": "MAX",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-14",
"last_updated": "2012-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26017267A",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302031609",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.