Active NPI
Michael Joseph Sullivan, RPH
- Pharmacist
- Tucson, AZ
National Provider Identifier
1881720233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9959
- Practice address
- 1551 W St Marys Rd
Safeway # 255
Tucson, AZ 85745-3107 - Phone
- (520) 624-8230
- Fax
- (520) 624-8724
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 9959 | AZ | Primary |
Addresses
Primary practice location
1551 W St Marys Rd
Safeway # 255
Tucson, AZ 85745-3107
Mailing address
3901 N Avenida la Vallita
Tucson, AZ 85750
Phone (520) 733-7489
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0317099 | Other | AZ | NABP |
| 307191 | Other | AZ | AHCCCS |
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 |
|---|---|---|---|
| 9959 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881720233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 N AVENIDA LA VALLITA",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85750",
"telephone_number": "520-733-7489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1551 W ST MARYS RD",
"address_2": "SAFEWAY # 255",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857453107",
"telephone_number": "520-624-8230",
"fax_number": "520-624-8724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "9959",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "0317099",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "307191",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.