Individual provider Active NPI

Brian R Loucks, RPH

  • Pharmacist
  • Cooperstown, NY
National Provider Identifier
1811166531
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33416 Issued in NY
Practice address
100 Main Street
CVS Pharmacy 5034
Cooperstown, NY 13326
Phone
(607) 547-8791
Fax
(607) 544-1070
NPI assigned
Feb 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33416 NY Primary

Addresses

Primary practice location

100 Main Street
CVS Pharmacy 5034
Cooperstown, NY 13326

Mailing address

100 Main Street
CVS Pharmacy 5034
Cooperstown, NY 13326
Phone (607) 547-8791

Other identifiers 1

IdentifierTypeStateIssuer
00911431MedicaidNY

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
33416NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1811166531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "address_2": "CVS PHARMACY 5034",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-8791",
            "fax_number": "607-544-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "address_2": "CVS PHARMACY 5034",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-8791",
            "fax_number": "607-544-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUCKS",
        "first_name": "BRIAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "33416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00911431",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.