Individual provider Active NPI

Gary Sudbrink

  • Pharmacist
  • York, PA
National Provider Identifier
1861852766
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP043718R Issued in PA
Practice address
1850 Normandie Dr
York, PA 17408-1534
Phone
(717) 767-8805
NPI assigned
Mar 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP043718R PA Primary

Addresses

Primary practice location

1850 Normandie Dr
York, PA 17408-1534

Mailing address

225 Tamarack Dr
Denver, PA 17517-1712
Phone (717) 598-3500

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

LicenseStateTypeSpecialty
RP043718RPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1861852766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 TAMARACK DR",
            "city": "DENVER",
            "state": "PA",
            "postal_code": "175171712",
            "telephone_number": "717-598-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 NORMANDIE DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174081534",
            "telephone_number": "717-767-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDBRINK",
        "first_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP043718R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.