Active NPI
Victor So
- Pharmacist
- Elkhart, IN
National Provider Identifier
1972938751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26025251A
- Practice address
- 3551 Cassopolis St
Elkhart, IN 46514-6743 - Phone
- (224) 392-1799
- NPI assigned
- Sep 11, 2013
- 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 | 26025251A | IN | Primary |
Addresses
Primary practice location
3551 Cassopolis St
Elkhart, IN 46514-6743
Mailing address
6030 Mission TRL Apt 5
Granger, IN 46530-4025
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26025251A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1972938751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6030 MISSION TRL APT 5",
"city": "GRANGER",
"state": "IN",
"postal_code": "465304025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 CASSOPOLIS ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465146743",
"telephone_number": "224-392-1799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SO",
"first_name": "VICTOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-11",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26025251A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.