Active NPI
Samuel L Self Jr., RPH
- Pharmacist
- Hoover, AL
National Provider Identifier
1942590070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11556
- Practice address
- 5492 Magnolia Trce
Hoover, AL 35244-4533 - Phone
- (205) 982-5735
- NPI assigned
- Apr 11, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11556 | AL | Primary |
Addresses
Primary practice location
5492 Magnolia Trce
Hoover, AL 35244-4533
Mailing address
5492 Magnolia Trace
Hoover, AL 35244
Phone (205) 982-7353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11556 | Other | AL | ALABAMA STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 11556 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1942590070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5492 MAGNOLIA TRACE",
"city": "HOOVER",
"state": "AL",
"postal_code": "35244",
"telephone_number": "205-982-7353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5492 MAGNOLIA TRCE",
"city": "HOOVER",
"state": "AL",
"postal_code": "352444533",
"telephone_number": "205-982-5735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "SAMUEL",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-11",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "11556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA STATE BOARD OF PHARMACY",
"identifier": "11556",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hoover, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.