|Provider Name||MR. LAWRENCE ALAN GORDIN RPH|
|Provider Location Address||20311 GRANDE OAKS SHOPPES BLVD ESTERO, FL 33928|
|Provider Mailing Address||11462 PEMBROOK RUN ESTERO, FL 33928|
|NPI Entity Type||Individual|
|Is Sole Proprietor?||Yes|
|Is Organization Subpart?||N/A|
|Last Update Date||07-08-2007|
MR. LAWRENCE ALAN GORDIN RPH
20311 GRANDE OAKS SHOPPES BLVD
Phone: (239) 495-9013
Fax: (239) 495-7638
MR. LAWRENCE ALAN GORDIN RPH
11462 PEMBROOK RUN
Phone: (239) 495-2969
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||183500000X||Pharmacy Service Providers||Pharmacist||0202006174||VA||No|
Taxonomy Description: an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State|
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.