Individual provider Active NPI

Gary Osburn, R.PH.

  • Pharmacotherapy Pharmacist
  • Fort Gratiot, MI
National Provider Identifier
1841600244
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
5302023622 Issued in MI
Practice address
4775 24TH Ave
Fort Gratiot, MI 48059-3405
Phone
(810) 385-2133
Fax
(810) 385-2165
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 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 5302023622 MI Primary

Addresses

Primary practice location

4775 24TH Ave
Fort Gratiot, MI 48059-3405

Mailing address

4605 Buckingham Dr
Port Huron, MI 48060-7204
Phone (810) 982-0708

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
5302023622MIMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1841600244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 BUCKINGHAM DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607204",
            "telephone_number": "810-982-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593405",
            "telephone_number": "810-385-2133",
            "fax_number": "810-385-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBURN",
        "first_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MI",
            "license": "5302023622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.