Active NPI
Quintin Andrew Hacker, PHARMD
- Pharmacist
- Jenison, MI
National Provider Identifier
1821573932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302046860
- Practice address
- 550 Baldwin St
Jenison, MI 49428-9753 - Phone
- (616) 667-2010
- NPI assigned
- Sep 25, 2018
- 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 | 5302046860 | MI | Primary |
Addresses
Primary practice location
550 Baldwin St
Jenison, MI 49428-9753
Mailing address
2995 Waterchase Way SW Apt 103
Wyoming, MI 49519-5945
Phone (317) 258-6419
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302046860 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537833600000",
"number": "1821573932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2995 WATERCHASE WAY SW APT 103",
"city": "WYOMING",
"state": "MI",
"postal_code": "495195945",
"telephone_number": "317-258-6419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 BALDWIN ST",
"city": "JENISON",
"state": "MI",
"postal_code": "494289753",
"telephone_number": "616-667-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKER",
"first_name": "QUINTIN",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-25",
"last_updated": "2018-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302046860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.