DR. LARS E VARDAMAN (NPI# 1013281823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013281823 |
| Entity Type | Individual |
| Full Name | DR. LARS E VARDAMAN |
| Credential | PHARM D |
| Practice Address |
6525 N Illinois St Fairview Heights IL 62208-2001 |
| Practice Telephone | 6183972091 |
| Practice Fax Number | 6183972187 |
| Mailing Telephone | 6183972091 |
| Mailing Fax Number | 6183972187 |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 2010026072 | MO | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 051.294476 | IL | Pharmacy Service Providers |
| Street Address |
6525 N ILLINOIS ST |
| City | FAIRVIEW HEIGHTS |
| State | IL |
| Zip Code | 62208-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093047698 | Kelly Louis Marler | Pharmacist | 6525 N Illinois St, Fairview Heights, IL 62208-2001 | 2010-02-05 |
| 1356673578 | Amy Michele Welser | Pharmacist | 6525 N Illinois St, Fairview Heights, IL 62208-2001 | 2010-02-12 |
| 1285665349 | Kmart Stores of Illinois LLC | Pharmacy | 6525 N Illinois St, Fairview Heights, IL 62208-2001 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740829647 | Stephanie Lynn Arzavala-reed | Counselor | 8.5 Canty Lane, Fairview Heights, IL 62208 | 2019-12-26 |
| 1649822156 | Preferred Behavioral Health | Community/Behavioral Health | 141 Market Place Drive, Suite 100, Fairview Heights, IL 62208 | 2019-07-15 |
| 1164929055 | Itic Support Services Inc | Psychiatry & Neurology | 141 Market Pl Ste 100, Fairview Heights, IL 62208 | 2018-04-09 |
| 1023525102 | Karen E. Reinacher | Speech-Language Pathologist | 21 Circle Dr., Fairview Heights, IL 62208 | 2018-01-10 |
| 1316465297 | Rachel Moser | Behavioral Analyst | 9510 St. Clair Ave, Fairview Heights, IL 62208 | 2017-08-31 |
| 1952826471 | Tomika Eiland | Social Worker | 413 David Dr, Fairview Heights, IL 62208 | 2017-08-05 |
| 1194113852 | Rachel Logan | Social Worker | 10850 Lincoln Trail, Suite 16 #3, Fairview Heights, IL 62208 | 2015-01-05 |
| 1255746715 | Center for Advanced Medicine LLC | Internal Medicine | 5036 N Illinois St, Suite 1, Fairview Heights, IL 62208 | 2014-06-24 |
| 1033463393 | Katherine Johnson I | Physical Therapy Assistant | 320 N Ruby Ln, Fairview Heights, IL 62208 | 2012-11-07 |
| 1508118779 | Nicole Kovacic | Physical Therapy Assistant | 5501 Perrin Drive, Fairview Heights, IL 62208 | 2012-10-11 |
| Find all providers in zip 62208 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| 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. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265042691 | Nicholas Antonio Moore | Pharmacist | 604 Cherry Dr, Fairview Heights, IL 62208-2846 | 2020-07-31 |
| 1821574971 | Jennifer Allen | Pharmacist | 625 Lincoln Hwy, Fairview Heights, IL 62208-2121 | 2018-07-12 |
| 1942584149 | Richard Paul Donjon | Pharmacist | 6505 North Illinois St, Fairview Heights, IL 62208-2001 | 2011-10-06 |
| 1093047698 | Kelly Louis Marler | Pharmacist | 6525 N Illinois St, Fairview Heights, IL 62208-2001 | 2010-02-05 |
| 1689285702 | Amanda R Zahn | Pharmacist | 6505 N Illinois St, Fairview Heights, IL 62208-2001 | 2020-08-12 |
| 1932685450 | Thaddeus J Harmon | Pharmacist | 625 Lincoln Hwy, Fairview Heights, IL 62208-2121 | 2018-07-17 |
| 1952732059 | Emily K Powers | Pharmacist | 5003 N Illinois St, Fairview Heights, IL 62208 | 2013-11-29 |
| 1134552565 | Raj B Jhala | Pharmacist | 4701 N Illinois St, Fairview Heights, IL 62208-3416 | 2013-08-21 |
| 1720410731 | Keta Patel | Pharmacist | 4701 N Illinois St, Fairview Heights, IL 62208-3416 | 2013-07-31 |
| 1023372489 | Alex Charles Dow | Pharmacist | 4701 N Illinois St, Fairview Heights, IL 62208-3416 | 2012-07-01 |
| Find all providers in FAIRVIEW HEIGHTS | ||||
| City | FAIRVIEW HEIGHTS |
| Zip Code | 62208 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.