Active NPI
Denis B Goudreau, R.PH.
- Pharmacist
- Ormond Beach, FL
National Provider Identifier
1982860730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0020183
- Practice address
- 115 N Saint Andrews Dr
Ormond Beach, FL 32174-3840 - Phone
- (386) 672-9013
- Fax
- (386) 672-9013
- NPI assigned
- Jul 31, 2008
- 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 | PS0020183 | FL | Primary |
Addresses
Primary practice location
115 N Saint Andrews Dr
Ormond Beach, FL 32174-3840
Mailing address
115 N Saint Andrews Dr
Ormond Beach, FL 32174-3840
Phone (386) 672-9013
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 |
|---|---|---|---|
| PS0020183 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1982860730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 N SAINT ANDREWS DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321743840",
"telephone_number": "386-672-9013",
"fax_number": "386-672-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N SAINT ANDREWS DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321743840",
"telephone_number": "386-672-9013",
"fax_number": "386-672-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUDREAU",
"first_name": "DENIS",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0020183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.