Individual provider Active NPI

Gregory Danylyk

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1962688960
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
A1-0003316 Issued in DE
Practice address
12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346
Phone
(314) 325-3982
NPI assigned
Jan 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X A1-0003316 DE Primary

Addresses

Primary practice location

12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346

Mailing address

558 Tullamore Rd
Magnolia, DE 19962-2601

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
A1-0003316DEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1962688960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 TULLAMORE RD",
            "city": "MAGNOLIA",
            "state": "DE",
            "postal_code": "199622601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12647 OLIVE BLVD STE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416346",
            "telephone_number": "314-325-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANYLYK",
        "first_name": "GREGORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0003316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; 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.