Active NPI
Michael Charles Broge, RPH
- Pharmacist
- Adrian, MI
National Provider Identifier
1992019855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302021846
- Practice address
- 945 Hillcrest Dr
Adrian, MI 49221-1409 - Phone
- (517) 265-3605
- Fax
- (517) 458-7758
- NPI assigned
- Aug 3, 2010
- 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 | 5302021846 | MI | Primary |
Addresses
Primary practice location
945 Hillcrest Dr
Adrian, MI 49221-1409
Mailing address
945 Hillcrest Drive
Adrian, MI 49221
Phone (517) 265-3605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302021846 | Other | MI | REGISTERED PHARMACIST |
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 |
|---|---|---|---|
| 5302021846 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1992019855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 HILLCREST DRIVE",
"city": "ADRIAN",
"state": "MI",
"postal_code": "49221",
"telephone_number": "517-265-3605",
"fax_number": "517-458-7758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 HILLCREST DR",
"city": "ADRIAN",
"state": "MI",
"postal_code": "492211409",
"telephone_number": "517-265-3605",
"fax_number": "517-458-7758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROGE",
"first_name": "MICHAEL",
"middle_name": "CHARLES",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-03",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302021846",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST",
"identifier": "5302021846",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Adrian, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.