PHARMACY DIRECT DELIVERY LLC (NPI# 1255753869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255753869 |
| Entity Type | Organization |
| Organization Name | PHARMACY DIRECT DELIVERY LLC |
| Other Organization Name | FREEDOM PHARMACY |
| Practice Address |
434 Hurricane Ln Ste 200 Williston VT 05495-2073 |
| Practice Telephone | 8026553544 |
| Practice Fax Number | 8026550123 |
| Mailing Telephone | 8026553544 |
| Mailing Fax Number | 8026550123 |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | MR. COREY JAMES DUTEAU (MEMBER) |
| Authorized Official Telephone | 8026553544 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 033054 | NY | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
NR0990 | NH | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2143851 | 01 | |
| VT | STATE LICENSE | 038.0134046 | 01 |
| NH | STATE LICENSE | NR0990 | 01 |
| NY | STATE LICENSE | 033054 | 01 |
| VT | 1022646 | 05 | |
| NH | 3095901 | 05 |
| Other Name | Type Code |
|---|---|
| Freedom Pharmacy | Doing Business As Name - Organization |
| Street Address |
434 HURRICANE LN STE 200 |
| City | WILLISTON |
| State | VT |
| Zip Code | 05495-2073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356302889 | Corey James Duteau | Pharmacist | 434 Hurricane Ln Ste 200, Williston, VT 05495-2073 | 2006-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588271977 | Rachel D. Oblak | Counselor | 8031 Williston Rd. Suite 2, Williston, VT 05495 | 2020-09-29 |
| 1164986386 | Caitlin Taylor Henck | Behavioral Analyst | 37 Talcott Road, Williston, VT 05495 | 2019-01-23 |
| 1497273585 | Williston Health Supplies | Durable Medical Equipment & Medical Supplies | 34 Blair Park Road, Suite 104 #302, Williston, VT 05495 | 2017-09-08 |
| 1245755057 | Jennifer L Cadorette | Physical Therapist | 1193 S Brownell Rd Ste 20, Williston, VT 05495 | 2017-08-14 |
| 1538563317 | Pamela Guiduli Nash | Psychologist | 277 Blair Park, Suite 210, Williston, VT 05495 | 2014-10-22 |
| 1205277118 | Daniel J Cho | Dentist | 62 Merchants Row, Williston, VT 05495 | 2013-07-09 |
| 1134473218 | Vermont Technical College Department of Denta | Dentist | 301 Lawrence Place, Williston, VT 05495 | 2012-10-29 |
| 1689923864 | Megan Marie Quiet | Specialist/Technologist | 115 Wellness Drive, Williston, VT 05495 | 2012-09-05 |
| 1285981365 | Allison Marie Bogan | Chiropractor | 300 Cornerstone Dr. Ste 215, Williston, VT 05495 | 2012-08-08 |
| 1114229937 | Bayada Home Health Care, Inc. | Registered Nurse | 600 Blair Park Rd Ste 300, Williston, VT 05495 | 2010-11-30 |
| Find all providers in zip 05495 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043327224 | Kph Healthcare Services, Inc. | Pharmacy | 600 Blair Park Rd Ste 195, Williston, VT 05495-7529 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558477232 | Rjw Inc | Pharmacy | 248 Stratton Rd, Rutland, VT 05701-4623 | 2006-08-22 |
| 1194241489 | Smith Management Services, LLC | Pharmacy | 252 Stratton Rd, Rutland, VT 05701-4623 | 2017-08-17 |
| 1972045839 | Pharmacy Health Services Inc | Pharmacy | 252 Stratton Rd, Rutland, VT 05701-4623 | 2016-11-09 |
| 1417390295 | Porter Hospital, Inc. | Pharmacy | 115 Porter Dr, Middlebury, VT 05753-8423 | 2013-04-11 |
| 1780881342 | Extended Care Pharmacy LLC | Pharmacy | 207 North St, Bennington, VT 05201-1829 | 2007-06-28 |
| 1073606364 | Mcgrx Inc | Pharmacy | 321 Main St, Suite B, Winooski, VT 05404-1380 | 2006-10-01 |
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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.