Individual provider Active NPI

Douglass T Agoabin, PHARMD

  • Pharmacist
  • Saginaw, MI
National Provider Identifier
1982260063
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302047703 Issued in MI
Practice address
409 W Genesee Ave
Saginaw, MI 48602-5513
Phone
(989) 755-2251
NPI assigned
May 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302047703 MI Primary

Addresses

Primary practice location

409 W Genesee Ave
Saginaw, MI 48602-5513

Mailing address

409 W Genesee Ave
Saginaw, MI 48602-5513
Phone (989) 755-2251

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302047703MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1982260063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W GENESEE AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025513",
            "telephone_number": "989-755-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W GENESEE AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025513",
            "telephone_number": "989-755-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOABIN",
        "first_name": "DOUGLASS",
        "middle_name": "T",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302047703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.