Active NPI
Andrew Wagner, PHARMD
- Pharmacist
- Lafayette, AL
National Provider Identifier
1992072151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16837
- Practice address
- 4295 County Road 12
Lafayette, AL 36862-5209 - Phone
- (334) 332-1661
- NPI assigned
- Nov 16, 2011
- Last updated
- Nov 16, 2011
- 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 | 16837 | AL | Primary |
Addresses
Primary practice location
4295 County Road 12
Lafayette, AL 36862-5209
Mailing address
4295 County Road 12
Lafayette, AL 36862-5209
Phone (334) 332-1661
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16837 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1992072151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4295 COUNTY ROAD 12",
"city": "LAFAYETTE",
"state": "AL",
"postal_code": "368625209",
"telephone_number": "334-332-1661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4295 COUNTY ROAD 12",
"city": "LAFAYETTE",
"state": "AL",
"postal_code": "368625209",
"telephone_number": "334-332-1661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "ANDREW",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-16",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "16837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.