Individual provider Active NPI

George Michael Cullina, PHARMD

  • Ambulatory Care Pharmacist
  • Willmar, MN
National Provider Identifier
1861973356
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
123984 Issued in MN
Practice address
101 Willmar Ave SW
Willmar, MN 56201-3556
Phone
(320) 214-6962
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 123984 MN Primary

Addresses

Primary practice location

101 Willmar Ave SW
Willmar, MN 56201-3556

Mailing address

1605A Olena Ave SE
Willmar, MN 56201-4769
Phone (708) 705-4422

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

LicenseStateTypeSpecialty
123984MNMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1861973356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605A OLENA AVE SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014769",
            "telephone_number": "708-705-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013556",
            "telephone_number": "320-214-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLINA",
        "first_name": "GEORGE",
        "middle_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MN",
            "license": "123984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.

Verify at the official NPI Registry.