Active NPI
John J Policello, RPH
- Pharmacist
- Deforest, WI
National Provider Identifier
1972693034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- R8456
- Practice address
- 645 S Main St
De Forest, WI 53532-1421 - Phone
- (608) 846-4736
- Fax
- (608) 846-6892
- NPI assigned
- Oct 12, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | R8456 | WI | Primary |
Addresses
Primary practice location
645 S Main St
De Forest, WI 53532-1421
Mailing address
1514 Parmenter St
Middleton, WI 53562-3628
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 |
|---|---|---|---|
| R8456 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972693034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 PARMENTER ST",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535623628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 S MAIN ST",
"city": "DE FOREST",
"state": "WI",
"postal_code": "535321421",
"telephone_number": "608-846-4736",
"fax_number": "608-846-6892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLICELLO",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "R8456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deforest, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.