Individual provider Active NPI

Thomas Joseph Olczak

  • Pharmacist
  • Clarkston, MI
National Provider Identifier
1922384445
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302021811 Issued in MI
Practice address
7110 Dixie Hwy
Clarkston, MI 48346-2014
Phone
(248) 922-1231
Fax
(248) 922-1430
NPI assigned
Oct 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302021811 MI Primary

Addresses

Primary practice location

7110 Dixie Hwy
Clarkston, MI 48346-2014

Mailing address

7110 Dixie Hwy
Clarkston, MI 48346-2014
Phone (248) 922-1231

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

State licenses

LicenseStateTypeSpecialty
5302021811MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1922384445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 DIXIE HWY",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462014",
            "telephone_number": "248-922-1231",
            "fax_number": "248-922-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 DIXIE HWY",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462014",
            "telephone_number": "248-922-1231",
            "fax_number": "248-922-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLCZAK",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302021811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.