NPIMap

Individual provider Active NPI

Lawrence Paul Borrusch, RPH

  • Pharmacist
  • Petoskey, MI
National Provider Identifier
1871892471
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302021030 Issued in MI
Practice address
1133 N US Highway 31
Petoskey, MI 49770-9305
Phone
(231) 348-2767
Fax
(231) 487-0755
NPI assigned
Mar 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 5302021030 MI Primary

Addresses

Primary practice location

1133 N US Highway 31
Petoskey, MI 49770-9305

Mailing address

1133 N US Highway 31
Petoskey, MI 49770-9305
Phone (231) 348-2767

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
5302021030MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Michigan Inc Past Accepting new patients
Rite Aid of Michigan Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1871892471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 N US HIGHWAY 31",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709305",
            "telephone_number": "231-348-2767",
            "fax_number": "231-487-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 N US HIGHWAY 31",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709305",
            "telephone_number": "231-348-2767",
            "fax_number": "231-487-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRUSCH",
        "first_name": "LAWRENCE",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302021030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.