Active NPI
Alan L Mackereth, RPH
- Pharmacotherapy Pharmacist
- Monticello, MN
National Provider Identifier
1912229329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 112363
- Practice address
- 1013 Hart Blvd
Monticello, MN 55362-8575 - Phone
- (763) 271-2251
- Fax
- (763) 271-2346
- NPI assigned
- Feb 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 112363 | MN | Primary |
Addresses
Primary practice location
1013 Hart Blvd
Monticello, MN 55362-8575
Mailing address
1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 271-2251
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 |
|---|---|---|---|
| 112363 | MN | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267142400000",
"number": "1912229329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 HART BLVD",
"city": "MONTICELLO",
"state": "MN",
"postal_code": "553628575",
"telephone_number": "763-271-2251",
"fax_number": "763-271-2346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 HART BLVD",
"city": "MONTICELLO",
"state": "MN",
"postal_code": "553628575",
"telephone_number": "763-271-2251",
"fax_number": "763-271-2346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKERETH",
"first_name": "ALAN",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-26",
"last_updated": "2010-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MN",
"license": "112363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.