DR. MICHAEL JESSE VERDUGO PHARM.D. MS NPI 1336231711

NPI Information

NPI: 1336231711
Provider Name: DR. MICHAEL JESSE VERDUGO, PHARM.D., MS
Classification: Pharmacist - 1835P0018X
Entity Type: Individual

Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Address:
283 HAYBINE DRIVE
SHENANDOAH JUNCTION, WV
ZIP 25442
Phone: (520) 440-6396
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DR. Michael Jesse Verdugo, PHARM.D., MS is a pharmacist clinician (phc)/ clinical pharmacy specialist pharmacist in Shenandoah Junction, WV. The provider is pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. DR. Michael Jesse Verdugo, PHARM.D., MS NPI is 1336231711. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

283 HAYBINE DRIVE
SHENANDOAH JUNCTION, WV
ZIP 25442
Phone: (520) 440-6396

The enumeration date for this NPI number is 9/29/2006 and was last updated on 9/28/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LASAC-15283	ARIZONA	No
2	183500000X	Pharmacist		119588	MINNESOTA	No
3	183500000X	Pharmacist		6179	WEST VIRGINIA	No
4	183500000X	Pharmacist		12494	ARIZONA	No
5	183500000X	Pharmacist		51262	CALIFORNIA	No
6	1835P0018X	Pharmacist	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	APH-10147	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6179	OTHER	WEST VIRGINIA	PHARMACIST LICENSE
2	LASAC-15283	OTHER	ARIZONA	ASSOCIATE SUBSTANCE ABUSE COUNSELOR
3	119588	OTHER	MINNESOTA	PHARMACIST LICENSE
4	474690000	MEDICAID	MINNESOTA
5	51262	OTHER	CALIFORNIA	PHARMACIST LICENSE
6	12494	OTHER	ARIZONA	PHARMACIST LICENSE
7	APH-10147	OTHER	CALIFORNIA	ADVANCED PRACTICE PHARMACIST LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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