Individual provider Active NPI

Paul Sepuka, RPH

  • Pharmacist
  • Peoria, AZ
National Provider Identifier
1871880955
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S014520 Issued in AZ
Practice address
8055 W Bell Rd
Peoria, AZ 85382-3806
Phone
(623) 979-4484
Fax
(623) 979-4484
NPI assigned
Jul 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S014520 AZ Primary

Addresses

Primary practice location

8055 W Bell Rd
Peoria, AZ 85382-3806

Mailing address

8055 W Bell Rd
Peoria, AZ 85382-3806
Phone (623) 979-4484

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
S014520AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1871880955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 W BELL RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823806",
            "telephone_number": "623-979-4484",
            "fax_number": "623-979-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8055 W BELL RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823806",
            "telephone_number": "623-979-4484",
            "fax_number": "623-979-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPUKA",
        "first_name": "PAUL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S014520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.