Active NPI
Heather Patricia Fasulo, RPH
- Pharmacist
- Sault Ste Marie, MI
National Provider Identifier
1871876474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302030720
- Practice address
- 2101 Ashmun Street
Walgreens
Sault Ste Marie, MI 47983 - Phone
- (906) 632-5135
- NPI assigned
- Sep 21, 2011
- Last updated
- Sep 21, 2011
- Sex
- Female
- 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 | 5302030720 | MI | Primary |
Addresses
Primary practice location
2101 Ashmun Street
Walgreens
Sault Ste Marie, MI 47983
Mailing address
106 Hood Street
Sault Ste Marie, ONTARIO P6C 6E5
CA
Phone (705) 971-8161
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302030720 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1871876474",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "106 HOOD STREET",
"city": "SAULT STE MARIE",
"state": "ONTARIO",
"postal_code": "P6C 6E5",
"telephone_number": "705-971-8161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ASHMUN STREET",
"address_2": "WALGREENS",
"city": "SAULT STE MARIE",
"state": "MI",
"postal_code": "47983",
"telephone_number": "906-632-5135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASULO",
"first_name": "HEATHER",
"middle_name": "PATRICIA",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302030720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sault Ste Marie, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.