Active NPI
Bonavy Gusack, PHARM.D.
- Pharmacist
- Togus, ME
National Provider Identifier
1891855599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR5279
- Practice address
- 1 VA Medical Center
VA Medical Center
Togus, ME 04330 - Phone
- (207) 623-8411
- NPI assigned
- Dec 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | PR5279 | ME | Primary |
Addresses
Primary practice location
1 VA Medical Center
VA Medical Center
Togus, ME 04330
Mailing address
PO Box 3041
Augusta, ME 04330-3041
Phone (315) 280-6726
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 |
|---|---|---|---|
| PR5279 | ME | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891855599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3041",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043303041",
"telephone_number": "315-280-6726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VA MEDICAL CENTER",
"address_2": "VA MEDICAL CENTER",
"city": "TOGUS",
"state": "ME",
"postal_code": "04330",
"telephone_number": "207-623-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSACK",
"first_name": "BONAVY",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR5279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Togus, ME
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.