Active NPI
Adrian Laertes Goram, PHARM D
- Pharmacist
- Pensacola, FL
National Provider Identifier
1891760377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS22060
- Practice address
- 2237 W 9 Mile Rd
Walgreens Store 10181
Pensacola, FL 32534 - Phone
- (850) 473-0286
- Fax
- (850) 473-0579
- NPI assigned
- Feb 20, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS22060 | FL | Primary |
| Pharmacist | 183500000X | 11692 | AL | |
| Pharmacist | 183500000X | 0202012246 | VA |
Addresses
Primary practice location
2237 W 9 Mile Rd
Walgreens Store 10181
Pensacola, FL 32534
Mailing address
4105 Bamboo Dr
Pensacola, FL 32526
Phone (850) 944-7368
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11692 | AL | MD | Pharmacist |
| PS22060 | FL | MD | Pharmacist |
| 0202012246 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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.
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1891760377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 BAMBOO DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "32526",
"telephone_number": "850-944-7368",
"fax_number": "850-944-7428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2237 W 9 MILE RD",
"address_2": "WALGREENS STORE 10181",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "32534",
"telephone_number": "850-473-0286",
"fax_number": "850-473-0579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORAM",
"first_name": "ADRIAN",
"middle_name": "LAERTES",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-20",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS22060",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "11692",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202012246",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.