Reuben Dale Antero, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

03439227 Issued in OH

Practice address

212 W Bagley Rd
Berea, OH 44017-1830

Phone

(440) 243-6676

NPI assigned

Jan 4, 2013

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 23, 2020.

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1922345388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 PINE ACRES BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064952",
            "telephone_number": "631-612-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171830",
            "telephone_number": "440-243-6676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Pine Acres Blvd",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117064952",
            "country_code": "US",
            "telephone_number": "631-612-0315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTERO",
        "first_name": "REUBEN",
        "middle_name": "DALE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-04",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "660419-1",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03439227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Berea, OH
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.