PAMELA HENDERSHOT (NPI# 1144756610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144756610 |
Entity Type | Individual |
Full Name | PAMELA HENDERSHOT |
Credential | RPH |
Practice Address |
110 S Main St Vicksburg MI 49097-1211 |
Practice Telephone | 2696491476 |
Practice Fax Number | 2696494007 |
Mailing Telephone | 2696491476 |
Mailing Fax Number | 2696494007 |
Enumeration Date | 2017-05-03 |
Last Update Date | 2017-05-03 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | 5302027022 | MI | Pharmacy Service Providers |
Street Address |
110 S MAIN ST |
City | VICKSBURG |
State | MI |
Zip Code | 49097-1211 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598990525 | Kelly Ann Soekarmoen | Pharmacist | 110 S Main St, Vicksburg, MI 49097-1211 | 2009-05-19 |
1184670085 | Hill's Pharmacy of Vicksburg, Inc. | Pharmacy | 110 S Main St, Vicksburg, MI 49097-1211 | 2006-05-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912132168 | Jo Lynne Kirchhoff | Pharmacist | 110 S. Main Streets, Vicksburg, MI 49097 | 2009-05-18 |
1558429605 | Ellen Marie Tavarone | Dentist | 602 West Prairie St, Vicksburg, MI 49097 | 2006-12-04 |
1598875601 | Robert L Dornbos Dds PC | Dentist | 102 S Main, Vicksburg, MI 49097 | 2006-08-30 |
1982680468 | Freds Super Pharmacy Inc | Pharmacy | 121 W Prairie St, Vicksburg, MI 49097 | 2005-12-16 |
1477853422 | South County Home Health Providers | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 115 N 3rd St, Vicksburg, MI 49097-1017 | 2010-10-25 |
1023214921 | Aaron C Ford | Dentist | 602 W Prairie St, Vicksburg, MI 49097-1178 | 2007-06-26 |
1154573392 | Family & Children Services, Inc. | Clinic/Center | 101 S Main St, Vicksburg, MI 49097-1210 | 2008-10-21 |
1982684916 | Robert L Dornbos | Dentist | 102 S Main St, Vicksburg, MI 49097-1211 | 2006-01-17 |
1326206186 | Vicksburg Optometry LLC | Eyewear Supplier (Equipment, not the service) | 124 E Prairie Street, Vicksburg, MI 49097-1257 | 2008-05-29 |
1417042276 | Maria Lyn Shoop Davenport | Optometrist | 124 E Prairie St, Vicksburg, MI 49097-1257 | 2006-10-04 |
Find all providers in zip 49097 |
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 |
---|---|---|---|---|
1093353047 | Virginia Leo Black | Pharmacist | 6010 Castle Rd, Vicksburg, MS 39180-9310 | 2019-12-19 |
1245706803 | Jacenta Matthews | Pharmacist | 1435 N Frontage Rd, Vicksburg, MS 39180-5170 | 2018-10-22 |
1033409669 | Logan Kelley | Pharmacist | 2310 Clay St, Vicksburg, MS 39183-3123 | 2011-04-16 |
1225327588 | Kimberly Nicole Laws | Pharmacist | 3046 Indiana Ave, Vicksburg, MS 39180-5252 | 2011-04-06 |
1912132168 | Jo Lynne Kirchhoff | Pharmacist | 110 S. Main Streets, Vicksburg, MI 49097 | 2009-05-18 |
1770615353 | Dennis Mark Beaman | Pharmacist | 15047 Jimmy Dr, Vicksburg, MI 49097-9764 | 2007-03-10 |
1609952175 | Durst Discount Drugs, Inc | Pharmacist | 2122 Clay St, Vicksburg, MS 39183-3119 | 2006-10-27 |
1568548022 | Durst Discount Drugs, Inc. | Pharmacist | 3117 Halls Ferry Rd, Vicksburg, MS 39180-5109 | 2006-10-27 |
1447355607 | People's Drug Store Inc | Pharmacist | 1521 Washington St, Vicksburg, MS 39180-3539 | 2006-09-13 |
1467485839 | Colonial Discount Drugs | Pharmacist | 1017 Mission 66, Vicksburg, MS 39183-2753 | 2006-07-09 |
Find all providers in VICKSBURG |
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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.