JUSTIN WAGNER (NPI# 1245647700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245647700 |
| Entity Type | Individual |
| Full Name | JUSTIN WAGNER |
| Practice Address |
1650 W Maloney Ave Gallup NM 87301-3305 |
| Practice Telephone | 5057223823 |
| Mailing Telephone | 5057223823 |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 18855 | IA | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 13889 | NV | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | RP00007923 | NM | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871818484 | Justin Philip Wagner | Surgery | 200 Ucla Medical Plz # 265, Los Angeles, CA 90095-8344 | 2010-04-07 |
| 1669451472 | Justin Roman Wagner | Specialist | Rec Center Physical Therapy, 400 Collins Rd Ne 154-100, Cedar Rapids, IA 52498-0001 | 2006-01-10 |
| 1871121798 | Justin John Wagner | Student in an Organized Health Care Education/Training Program | 2601 Ocean Pkwy, Brooklyn, NY 11235-7745 | 2020-03-27 |
| 1356608004 | Justin Timothy Wagner | Radiology | 804 Service Rd, Room D100, East Lansing, MI 48824-7021 | 2012-04-19 |
| 1306051362 | Justin B Wagner | Emergency Medicine | 1650 Creekside Dr, Folsom, CA 95630-3400 | 2007-05-13 |
| Street Address |
1650 W MALONEY AVE |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346267499 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1650 W Maloney Ave, Gallup, NM 87301-3305 | 2006-07-16 |
| 1245648047 | Mark Newman | Pharmacist | 1650 W Maloney Ave, Gallup, NM 87301-3305 | 2014-07-25 |
| 1497837926 | Wal-mart Stores East, Lp | Technician/Technologist | 1650 W Maloney Ave, Gallup, NM 87301-3305 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| 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 |
|---|---|---|---|---|
| 1548737885 | Mohannad Rashid | Pharmacist | 907 W Coal Ave, Gallup, NM 87301-6643 | 2018-10-24 |
| 1801301908 | Keith Alan Whiteman | Pharmacist | 1870 E Historic Highway 66, Gallup, NM 87301-4955 | 2017-12-12 |
| 1023496056 | Andrew Wade Sun | Pharmacist | 900 Boardman Dr, Apt C 18, Gallup, NM 87301-4774 | 2015-05-11 |
| 1366703381 | Chakravarthy Chalamala | Pharmacist | 980 North Highway 491, Safeway Pharmacy, Gallup, NM 87301 | 2012-06-06 |
| 1962783761 | Jason Jaramillo | Pharmacist | 1870 E Hwy 66, Gallup, NM 87301-6135 | 2011-09-07 |
| 1821247784 | Jeffery Alan Ward | Pharmacist | 205 Cactus Rd, Gallup, NM 87301-5774 | 2008-09-16 |
| 1811168610 | Patrick Seth Moore | Pharmacist | 220 E Crestwood Ct, Gallup, NM 87301-7120 | 2008-03-19 |
| 1215115571 | Stephanie Michelle Rodriguez | Pharmacist | 980 Us Highway 491, Gallup, NM 87301-5339 | 2008-02-07 |
| 1770183733 | Logan Smolla | Pharmacist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-29 |
| 1912505496 | Tyson Walker | Pharmacist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-15 |
| Find all providers in GALLUP | ||||
Please comment or provide details below to improve the information on JUSTIN WAGNER.
| 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.