Active NPI
Gregory Penko, RPH
- Geriatric Pharmacist
- Westlake, OH
National Provider Identifier
1912447707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 03225386
- Practice address
- 24165 Detroit Rd
Westlake, OH 44145-1516 - Phone
- (866) 883-7646
- Fax
- (866) 617-9047
- NPI assigned
- Feb 28, 2017
- 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 |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 03225386 | OH | Primary |
Addresses
Primary practice location
24165 Detroit Rd
Westlake, OH 44145-1516
Mailing address
24165 Detroit Rd
Westlake, OH 44145-1516
Phone (866) 883-7646
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 |
|---|---|---|---|
| 03225386 | OH | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1912447707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24165 DETROIT RD",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441451516",
"telephone_number": "866-883-7646",
"fax_number": "866-617-9047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24165 DETROIT RD",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441451516",
"telephone_number": "866-883-7646",
"fax_number": "866-617-9047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENKO",
"first_name": "GREGORY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-28",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "OH",
"license": "03225386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westlake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.