Russell E Mancewicz, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302411128 Issued in MI

Practice address

2045 S I 75 Business Loop
Grayling, MI 49738-2039

Phone

(989) 344-0374

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Grayling, MI
  • NPI 1720248859
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1871536300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 S I 75 BUSINESS LOOP",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497382039",
            "telephone_number": "989-344-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 S I 75 BUSINESS LOOP",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497382039",
            "telephone_number": "989-344-0374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17001 Newburgh Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481541610",
            "country_code": "US",
            "telephone_number": "734-748-3819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCEWICZ",
        "first_name": "RUSSELL",
        "middle_name": "E",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302411128",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5315104396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Marie Loudenslager, LLMSW
• Love Bugs Counseling PLLC
• Wesley Wendell Lynch, FNP-C
• Jessica Machue, MD
• Jennifer Malicowski, DDS
• Marco Mares-Saihua
• Mark W. Davey, DDS, PC
• Dallas Martin
• Ashton Nicole McDaniels
• Ruth Marie McDonald

• Pharmacist in Grayling, MI
• Providers in Grayling, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.