Active NPI
Robert L Golden Jr.
- Pharmacist
- Deatsville, AL
National Provider Identifier
1841545217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6188
- Practice address
- 95 Lightwood Rd
Deatsville, AL 36022-3494 - Phone
- (334) 569-2112
- Fax
- (334) 569-1143
- NPI assigned
- Jul 20, 2012
- Last updated
- Jul 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | 6188 | AL | Primary |
Addresses
Primary practice location
95 Lightwood Rd
Deatsville, AL 36022-3494
Mailing address
95 Lightwood Rd
Deatsville, AL 36022-3494
Phone (334) 569-2112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100001378 | Medicaid | AL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6188 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Pharmacy LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Deatsville, AL
- NPI 1437209616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342742400000",
"number": "1841545217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 LIGHTWOOD RD",
"city": "DEATSVILLE",
"state": "AL",
"postal_code": "360223494",
"telephone_number": "334-569-2112",
"fax_number": "334-569-1143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 LIGHTWOOD RD",
"city": "DEATSVILLE",
"state": "AL",
"postal_code": "360223494",
"telephone_number": "334-569-2112",
"fax_number": "334-569-1143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDEN",
"first_name": "ROBERT",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-20",
"last_updated": "2012-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "6188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100001378",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deatsville, AL
- Deatsville Care Foundation, Inc. (Resurrection Life Center)
- Cody Brian Dingman, DPT
- Elite Rehab Holtville LLC
- Express Mro (Pine Level Family Care)
- William Donald Gill II, PT
- Justin Edward Henry
- Hoff
- Lisa Holmes, LPC
- Ivy Creek of Elmore, LLC (Ivy Creek Family Care of Holtville)
- Jackson Hospital and Clinic, Inc (Jackson Family Medicine Pine Level)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.