PORTVILLE PHARMACY,INC. (NPI# 1225191422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225191422 |
| Entity Type | Organization |
| Organization Name | PORTVILLE PHARMACY,INC. |
| Other Organization Name | DUNN'S DRUGSTORE |
| Practice Address |
323 Main St Bolivar NY 14715-1108 |
| Practice Telephone | 5859281530 |
| Practice Fax Number | 5859282972 |
| Mailing Telephone | 5859281530 |
| Mailing Fax Number | 5859282972 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MOIRA E AHL (SUPERVISING PHARMACIST) |
| Authorized Official Telephone | 5859281530 |
| Authorized Official Credential | PHARM.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 017472 | NY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00623309 | 05 |
| Other Name | Type Code |
|---|---|
| Dunn's Drugstore | Doing Business As Name - Organization |
| Street Address |
323 MAIN ST |
| City | BOLIVAR |
| State | NY |
| Zip Code | 14715-1108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750326195 | Portville Pharmacy Inc | Pharmacy | 323 Main St, Bolivar, NY 14715-1108 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134384357 | Tracie Dawn Edwards | Hearing Instrument Specialist | 7760 Route 417 W, Bolivar, NY 14715 | 2008-07-28 |
| 1740619154 | Robyn Sue Smith | Registered Nurse | 100 School Street, Bolivar, NY 14715 | 2013-11-06 |
| 1477176667 | The Memorial Hospital of William F and Gertrude F Jones | Clinic/Center | 120 1st St, Bolivar, NY 14715-1132 | 2020-05-21 |
| 1982689030 | Richard P Cudahy | Internal Medicine | 120 1st St, Bolivar, NY 14715-1132 | 2005-12-13 |
| 1043365471 | Bolivar-richburg Central School District | Local Education Agency (LEA) | 100 School St, Bolivar, NY 14715-1235 | 2007-01-24 |
| 1568864049 | Sara Johnson | Registered Nurse | 100 School St, Bolivar, NY 14715-1235 | 2014-09-16 |
| 1558644831 | Victoria M Hefner | Registered Nurse | 100 School St, Bolivar, NY 14715-1235 | 2011-09-23 |
| 1831481878 | Cassie Dora Craft | Licensed Practical Nurse | 82 Olive St, Bolivar, NY 14715-1310 | 2011-05-10 |
| 1447652250 | Jennifer Baxter | Licensed Practical Nurse | 82 Olive St, Bolivar, NY 14715-1310 | 2014-09-24 |
| 1164821526 | Maidie Andrews | Licensed Practical Nurse | 82 Olive St, Bolivar, NY 14715-1310 | 2014-08-21 |
| Find all providers in zip 14715 | ||||
| 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 |
|---|---|---|---|---|
| 1861868465 | Elizabeth Ashley Willis | Pharmacist | 1355 W Market St, Bolivar, TN 38008-1715 | 2015-08-18 |
| 1083919005 | Hope Caples Parker | Pharmacist | 109 Tennessee St, Bolivar, TN 38008-1822 | 2011-01-22 |
| 1972749794 | Sonja Lynn Obryan | Pharmacist | 1885 E Thornridge Dr, Bolivar, MO 65613-1283 | 2008-12-29 |
| 1952503914 | Leigh Boston Cummings | Pharmacist | 622 W Market St Ste 200, Bolivar, TN 38008-2241 | 2007-06-01 |
| 1649367335 | Dan Mchan | Pharmacist | 103 E Broadway, Bolivar, MO 65613-1621 | 2006-10-06 |
| 1437261062 | Sno White-benson | Pharmacist | 1100 S. Springfield Suite A, Suite 1, Bolivar, MO 65613-0158 | 2006-08-31 |
| 1932175965 | Jeff Sparks | Pharmacist | 2000b S Springfield Ave, Bolivar, MO 65613-9654 | 2006-02-28 |
| 1710591193 | John R Myers II | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2020-09-03 |
| 1912511296 | Robert Wilkins | Pharmacist | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2020-09-03 |
| 1568070217 | Cameron Tyler Hargrove | Pharmacist | 1604 W Market St, Bolivar, TN 38008-1536 | 2020-07-20 |
| Find all providers in BOLIVAR | ||||
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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.