NPI,First Name,Middle Name,Last Name,Name Prefix,Name Suffix,Credential,Gender,Mailing Address 1,Mailing Address 2,Mailing City,Mailing State,Mailing Postal Code,Mailing Telephone,Mailing Fax,Business Address 1,Business Address 2,Business City,Business State,Business Postal Code,Business Telephone Number,Business Fax Number,Type,Classification,Specialization,License Number,License State,Enumeration Date,Last Update Date
1487146767,MICHAEL,,MADDALENA,,,,Male,11428 117TH ST,,SOUTH OZONE PARK,NY,11420-1929,,,421 GLEN COVE RD,,ROSLYN HEIGHTS,NY,11577-1811,516-621-2929,,Pharmacy Service Providers,Pharmacist,,I062220,NY,06-04-18,06-04-18
1114469947,MELISSA,,FERGUSON,,,PHARMD,Female,820 N CHELAN AVE,,WENATCHEE,WA,98801-2028,509-663-8711,,820 N CHELAN AVE,,WENATCHEE,WA,98801,509-663-8711,,Pharmacy Service Providers,Pharmacist,Oncology,PH60659455,WA,11-10-16,06-04-18
1528550704,RICH,A.,LEVINE,MR.,,R.PH,Male,11753 SPERRY RD,,CHESTERLAND,OH,44026-1619,440-665-6353,,6780 MAYFIELD RD,,MAYFIELD HTS,OH,44124-2203,440-312-4874,,Pharmacy Service Providers,Pharmacist,,3215628,OH,06-04-18,06-04-18
1063904241,AMILCAR,,SANCHEZ CISNERO,,,,Male,8725 NW 13TH TER,,DORAL,FL,33172-3013,855-745-5725,,8725 NW 13TH TER,,DORAL,FL,33172-3013,855-745-5725,,Pharmacy Service Providers,Pharmacist,,PS57733,FL,06-04-18,06-04-18
1316439599,RANDIE,,OBERLENDER,MS.,,RPH,Female,71 SUNFLOWER WAY,,HUNTINGDON VALLEY,PA,19006-5450,215-938-0884,,1648 HUNTINGDON PIKE,,MEADOWBROOK,PA,19046-8001,215-938-3524,,Pharmacy Service Providers,Pharmacist,,RP032451L,PA,06-04-18,06-04-18
1598160665,ADRIAN,,STEPHENS,,,,Female,625 PIEDMONT AVE NE UNIT 4030,,ATLANTA,GA,30308-6211,561-719-2856,,80 JESSE HILL JR DR SE,,ATLANTA,GA,30303,470-839-6396,,Pharmacy Service Providers,Pharmacist,Ambulatory Care,40446,TN,10/30/2014,06-04-18
1619375995,ADJE,DABY,KOFFI,MR.,,,Male,1 BRISTLECONE DRIVE,,HOWELL,NJ,7731,215-459-8390,,671 MARTIN LUTHER KING BLVD,,NEWARK,NJ,7102,862-237-7601,862-237-7603,Pharmacy Service Providers,Pharmacist,,28RI03075400,NJ,12/18/2014,06-04-18
1023459666,RACHEL,,NAULT,,,PHARMD,Female,N5775 OLD LAKE RD,,SHAWANO,WI,54166-5322,920-213-5800,,100 COUNTY ROAD B,,SHAWANO,WI,54166,715-524-2161,,Pharmacy Service Providers,Pharmacist,,17055-40,WI,07-11-13,06-04-18
1134238785,LINDSEY,ANNE,FARRELL,DR.,,PHARM.D.,Female,1400 VFW PKWY,,WEST ROXBURY,MA,02132-4927,857-203-5460,,1400 VFW PKWY,,WEST ROXBURY,MA,2132,857-203-5460,,Pharmacy Service Providers,Pharmacist,,26407,MA,08/29/2006,06-04-18
1518459734,MARK,ALEXANDER,NELSON,,,,Male,111 ACKLEN PARK DR APT 117,,NASHVILLE,TN,37203-1144,720-660-5293,877-436-3472,111 ACKLEN PARK DR APT 117,,NASHVILLE,TN,37203-1144,720-660-5293,877-436-3472,Pharmacy Service Providers,Pharmacist,,42168,TN,06-04-18,06-04-18
1962994186,NEIL,PETER,THOMPSON,,,PHARMACIST,Male,4048 19TH AVE S,,MINNEAPOLIS,MN,55407-3402,612-246-4788,612-284-1022,4048 19TH AVE S,,MINNEAPOLIS,MN,55407-3402,612-246-4788,612-284-1022,Pharmacy Service Providers,Pharmacist,Geriatric,112703,MN,06-04-18,06-04-18
1578753935,JENNY,VAN,DU,,,,Female,14800 W MOUNTAIN VIEW BLVD STE 105,,SURPRISE,AZ,85374-4796,623-476-5958,623-476-7391,14800 W MOUNTAIN VIEW BLVD STE 105,,SURPRISE,AZ,85374-4796,623-476-5958,623-476-7391,Pharmacy Service Providers,Pharmacist,,55553,CA,07/31/2007,06-04-18
1053803288,MOHAMED,,ZEINEDDINE,,,PHARMD,Male,22376 ABBEY LN,,DEARBORN,MI,48124-2243,,,484 S TELEGRAPH RD,,MONROE,MI,48161-1612,734-240-2954,,Pharmacy Service Providers,Pharmacist,,5302043712,MI,06-04-18,06-04-18
1366796302,KEITH,,PATTERSON,DR.,JR.,PHARMD,Male,125 E SOUTH AIRPORT RD,PHARMACY,TRAVERSE CITY,MI,49686,231-252-7010,231-252-7001,125 E SOUTH AIRPORT RD,PHARMACY,TRAVERSE CITY,MI,49686,231-252-7010,231-252-7001,Pharmacy Service Providers,Pharmacist,,5302039014,MI,10/30/2012,06-04-18
1396237525,CHRISTINE,NGOC,PHAM,,,PHARM.D,Female,8662 MARYLEE DR,,GARDEN GROVE,CA,92841-2220,714-583-9522,,8662 MARYLEE DR,,GARDEN GROVE,CA,92841-2220,714-583-9522,,Pharmacy Service Providers,Pharmacist,,78437,CA,06-04-18,06-04-18
1396237533,TUONG-VY,CHRISTINA,NGUYEN,,,,Female,12402 MCLEOD ST,,GARDEN GROVE,CA,92840-3108,714-260-5746,,12402 MCLEOD ST,,GARDEN GROVE,CA,92840-3108,714-260-5746,,Pharmacy Service Providers,Pharmacist,,RPH76451,CA,06-04-18,06-04-18
1518344936,TERRI,LYNN,SCIOSCIA,MRS.,,PHARM D,Female,1013 MATHEUS DR,,MURFREESBORO,TN,37128-7701,615-900-8089,,3625 MANSON PIKE UNIT 8210,,MURFREESBORO,TN,37129,973-303-9542,,Pharmacy Service Providers,Pharmacist,,T-15311,MS,05-05-15,06-04-18
1730671975,MICHAEL,,FEDERICO,,,PHARM D.,Male,2735 ASCOT DR,,SAN RAMON,CA,94583-2527,925-866-6160,,2735 ASCOT DRIVE,,SAN RAMON,CA,94583,925-866-6160,,Pharmacy Service Providers,Pharmacist,,53613,CA,06-04-18,06-04-18
1710479969,RACHEL,ALEXA,KASHTAN,,,,Female,28304 CHERRY BLOSSOM CT,,LAWRENCE TOWNSHIP,NJ,08648-1289,585-748-8502,,1801 KUSER RD,,TRENTON,NJ,08690-3705,609-585-3925,,Pharmacy Service Providers,Pharmacist,,28RI03890500,NJ,06-04-18,06-04-18
1790277945,HANNAH,HAN,NGUYEN,,,,Female,6250 VALLEY SPRINGS PKWY,,RIVERSIDE,CA,92507-0970,,,6250 VALLEY SPRINGS PKWY,,RIVERSIDE,CA,92507-0970,951-653-2969,,Pharmacy Service Providers,Pharmacist,,65148,CA,06-04-18,06-04-18
1063463289,JOHN,THOMAS,GUTHRIE,DR.,II,PHARM.D.,Male,8024 STAGE HILLS BLVD STE 107,,BARTLETT,TN,38133-4048,800-962-6339,901-382-3091,8024 STAGE HILLS BLVD STE 107,,BARTLETT,TN,38133,800-962-6339,901-382-3091,Pharmacy Service Providers,Pharmacist,,2017025972,MO,05-12-06,06-04-18
1306377379,JIHYUN,,YOON,,,,Female,211-06 39TH AVE,1ST FL,BAYSIDE,NY,11361-1911,,,136-58 39TH AVE,,FLUSHING,NY,11354,718-661-3377,718-661-3399,Pharmacy Service Providers,Pharmacist,,62676,NY,03/22/2017,06-04-18
1386136547,PIOTR,,CYMBALSKI,,,,Male,2040 ROUTE 130,,BURLINGTON,NJ,08016-9716,609-880-2393,609-880-2317,2040 ROUTE 130,,BURLINGTON,NJ,08016-9716,609-880-2393,609-880-2317,Pharmacy Service Providers,Pharmacist,,RP038637L,PA,06-04-18,06-04-18
1659863827,CASEY,THI,TRAN,MRS.,,PHARMD,Female,1620 FIRST ST,,LIVERMORE,CA,94550-4363,925-724-0131,,2995 YGNACIO VALLEY RD,,WALNUT CREEK,CA,94598-3535,925-256-7230,,Pharmacy Service Providers,Pharmacist,,76533,CA,06-04-18,06-04-18
1245616010,CINDY,,YEH,,,,Female,12704 GUY R BREWER BLVD,,JAMAICA,NY,11434-2955,718-978-4485,,12704 GUY R BREWER BLVD,,JAMAICA,NY,11434,718-978-4485,,Pharmacy Service Providers,Pharmacist,,60749,NY,08-04-15,06-04-18
1619469889,HEATHER,,MEHARG,,,PHARM D,Female,2000 BARRETT AVE,,ROYAL OAK,MI,48067-3506,734-718-7235,,1375 S LAPEER RD STE 103,,LAKE ORION,MI,48360-1421,248-929-8174,,Pharmacy Service Providers,Pharmacist,,61291088,IL,06-04-18,06-04-18
1255823423,JOSHUA,,MATLOCK,,,PHARMD,Male,PO BOX 516,,FRIDAY HARBOR,WA,98250-0516,360-378-4421,360-378-6140,210 SPRING ST,,FRIDAY HARBOR,WA,98250-7254,360-378-4421,360-378-6140,Pharmacy Service Providers,Pharmacist,,17540,OK,06-04-18,06-04-18
1538537733,HYUN CHAN,,CHO,,,,Male,15007 NORTHERN BLVD,,FLUSHING,NY,11354-4968,,,14903 NORTHERN BLVD,,FLUSHING,NY,11354,718-888-0101,718-358-0070,Pharmacy Service Providers,Pharmacist,,60841,NY,09-04-15,06-04-18
1184738684,CYNTHIA,,BOYER,DR.,,PHARM D,Female,4646 JOHN R ST,OUTPATIENT PHARMACY #118-CP,DETROIT,MI,48201-1916,313-576-3762,313-576-1105,4646 JOHN R ST,OUTPATIENT PHARMACY #118-CP,DETROIT,MI,48201,313-576-3762,313-576-1105,Pharmacy Service Providers,Pharmacist,,5302029944,MI,08/19/2006,06-04-18
1215429394,PHILLIP,C,LACY,,,CPHT,Male,1776 SW MADISON ST,,PORTLAND,OR,97205-1715,503-224-1044,503-621-2235,12360 E BURNSIDE ST,,PORTLAND,OR,97233-1042,971-279-4800,971-279-2051,Pharmacy Service Providers,Pharmacy Technician,,CPT-0011115,OR,06-04-18,06-04-18
1336631415,SARAH,LETHA,NOTTINGHAM,,,,Female,78 PERRY WINKLE LN,,HUNTINGTON,WV,25702-9506,304-736-8310,,78 PERRY WINKLE LN,,HUNTINGTON,WV,25702-9506,304-736-8310,,Pharmacy Service Providers,Pharmacist,,RP0007297,WV,06-04-18,06-04-18
1750873865,TANNER,,ROESSLEIN,DR.,,PHARMD,Male,7275 FOREST GLEN DR APT L,,ROCKFORD,IL,61114-8029,815-404-6876,,721 W SOUTH ST,,FREEPORT,IL,61032-6839,815-232-6129,,Pharmacy Service Providers,Pharmacist,,51.299506,IL,06-04-18,06-04-18
1366575334,MICHAEL,,MAGAHA,,,RPH,Male,1409 N MAIN ST,,ANDERSON,SC,29621-4732,864-224-3581,864-231-6240,1409 N MAIN ST,,ANDERSON,SC,29621,864-224-3581,864-231-6240,Pharmacy Service Providers,Pharmacist,,50001843,SC,03/13/2007,06-04-18
1801388921,DAN,THOMAS,WARE,,,RPH,Male,1866 MAIN ST,,HAYNESVILLE,LA,71038-4904,318-624-1053,318-624-2233,1866 MAIN ST,,HAYNESVILLE,LA,71038-4904,318-624-1053,318-624-2233,Pharmacy Service Providers,Pharmacist,,16250,LA,06-04-18,06-04-18
1861984999,MOLLY,,RUTTER,,,PHARMD,Female,412 MAYFIELD DR,,ANDERSON,SC,29625-2214,,,1063 S PENDLETON ST,,EASLEY,SC,29642-1040,864-859-2564,,Pharmacy Service Providers,Pharmacist,,37549,SC,06-04-18,06-04-18
1053686626,ASHLEY,ANNE,ADAMS,MS.,,"PHARMD,MSPT",Female,8651 PRESTON HWY,,LOUISVILLE,KY,40219-5305,502-969-1309,,289 IRELAND AVE,,FORT KNOX,KY,40121,502-624-6290,,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,15045,KY,03/15/2012,06-05-18
1821580960,MEGAN,E,LENZ,,,,Female,820 N CHELAN AVE,,WENATCHEE,WA,98801-2028,509-663-8711,,100 HIGHLINE DR,,EAST WENATCHEE,WA,98802-5341,509-663-8711,,Pharmacy Service Providers,Pharmacist,,IR60492756,WA,06-05-18,06-05-18
1932525011,KRISTIN,,SCANLAN,,,,Female,31 HAVENS AVE,,AUBURN,NY,13021-4215,315-406-8713,,4577 BUCKLEY RD,,LIVERPOOL,NY,13088,315-622-6135,,Pharmacy Service Providers,Pharmacist,,58992,NY,03-12-14,06-05-18
1720570880,ANDREW,,LEE,,,,Male,8268 164TH ST,,JAMAICA,NY,11432-1121,,,8268 164TH ST,,JAMAICA,NY,11432-1121,646-378-9578,,Pharmacy Service Providers,Pharmacist,,60955,NY,06-05-18,06-05-18
1558516278,DAMESHIA,,EDWARDS,DR.,,PHARMD,Female,4646 JOHN R,JOHN D. DINGELL MEDICAL CENTER-PHARMACY,DETROIT,MI,48201,313-576-1135,313-576-1105,4646 JOHN R ST,OUTPATIENT PHARMACY #118-CP,DETROIT,MI,48201,313-576-1135,313-576-1105,Pharmacy Service Providers,Pharmacist,,5302033657,MI,11/21/2008,06-05-18
1013290006,AMY,L,BAILEY,,,PHARMD,Female,5140 W BASELINE RD,,LAVEEN,AZ,85339-2971,602-237-7001,877-376-9490,5140 W BASELINE RD,,LAVEEN,AZ,85339,602-237-7001,877-376-9490,Pharmacy Service Providers,Pharmacist,,PH60251478,WA,09/26/2011,06-05-18
1407348469,JOSEE,,SASSEVILLE,,,PHARMACIST,Female,1801 L ST APT 202,,SACRAMENTO,CA,95811-4173,951-833-0473,,3661 TRUXEL RD,,SACRAMENTO,CA,95834-3617,916-928-9673,,Pharmacy Service Providers,Pharmacist,,57918,CA,06-05-18,06-05-18
1316439383,SARA,,MASSEY,,,,Female,172 6TH ST E APT 1102,,SAINT PAUL,MN,55101-1976,417-389-5901,,2020 E 28TH ST,,MINNEAPOLIS,MN,55407-1394,612-333-0770,,Pharmacy Service Providers,Pharmacist,,812863,MN,06-05-18,06-05-18
1871908442,RYAN,WILLIAM,HUNTSMAN,DR.,,PHARM.D.,Male,2121 N D ST,,SAN BERNARDINO,CA,92405,,,2121 N D ST,,SAN BERNARDINO,CA,92405,909-693-3376,,Pharmacy Service Providers,Pharmacist,,68175,CA,06/23/2014,06-05-18
1699267682,STEVEN,,WHITFIELD,,,,Male,12154 ALMEDA RD,,HOUSTON,TX,77045-3724,713-360-7993,713-492-2799,12154 ALMEDA RD,,HOUSTON,TX,77045-3724,713-360-7993,,Pharmacy Service Providers,Pharmacist,,26167,TX,06-05-18,06-05-18
1043702038,RYAN,,KLUMPP,,,,Male,93 W FOURTH ST STE A,,SUTTONS BAY,MI,49682-8408,231-271-6111,,93 W FOURTH ST STE A,,SUTTONS BAY,MI,49682-8408,231-271-6111,,Pharmacy Service Providers,Pharmacist,,5302038959,MI,06-05-18,06-05-18
1144711383,SAMUEL,RICHARD,MIKOVICH,DR.,,PHARMD,Male,820 N CHELAN AVE,,WENATCHEE,WA,98801-2028,509-663-8711,,820 N CHELAN AVE,,WENATCHEE,WA,98801,509-663-8711,,Pharmacy Service Providers,Pharmacist,,2017024212,MO,05/23/2018,06-05-18
1811489800,COLIN,,LAIRD,MR.,,,Male,133 BEAVER CREEK RD,,LOYSBURG,PA,16659-9626,814-766-3208,,3432 ROUTE 764 SUGAR RUN PLAZA,CARDINAL HEALTH,DUNCANSVILLE,PA,16635,814-942-2545,,Pharmacy Service Providers,Pharmacist,Nuclear,RP043982L,PA,06-05-18,06-05-18
1245722230,DEBRA,,WINTER,,,,Female,8110 E COUNTY ROAD 700 N,,BROWNSBURG,IN,46112-9069,317-544-9514,,1481 W 10TH ST,,INDIANAPOLIS,IN,46202-2803,317-988-2583,,Pharmacy Service Providers,Pharmacist,,26021427A,IN,06-05-18,06-05-18
1841782828,STEPHANIE,,LIANG,,,,Female,159 E GUN HILL RD,,BRONX,NY,10467-2160,,,159 E GUN HILL RD,,BRONX,NY,10467,718-885-6218,,Pharmacy Service Providers,Pharmacist,,62753,NY,06-05-18,06-05-18