MR. JUSTIN RUSSELL DOROTHEO (NPI# 1275990640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275990640 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN RUSSELL DOROTHEO |
| Credential | PHARMD |
| Practice Address |
Winslow Indian Healthcare Center (pharmacy Dept.) 500 Indiana Ave Winslow AZ 86047-7403 |
| Mailing Address |
3167 N Kyle Loop Flagstaff AZ 86004-1837 |
| Practice Telephone | 9282896215 |
| Mailing Telephone | 5617154749 |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2018-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PS55417 | FL | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | PSI29655 | FL | Pharmacy Service Providers |
| Street Address |
WINSLOW INDIAN HEALTHCARE CENTER (PHARMACY DEPT.) 500 INDIANA AVE |
| City | WINSLOW |
| State | AZ |
| Zip Code | 86047-7403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097350 | Kalp Juthani | Student in an Organized Health Care Education/Training Program | 500 N Indiana Avenue, Winslow, AZ 86047 | 2020-03-11 |
| 1104461268 | Dental Innovations-winslow | Clinic/Center | 722 Mike's Pike Street, #101, Winslow, AZ 86047 | 2019-11-13 |
| 1417505611 | Association of Indigenous Pioneers, Incorporated (aipi) | Non-emergency Medical Transport (VAN) | Nec Navajo Route 15 & 60, Suite #2, Winslow, AZ 86047 | 2019-08-30 |
| 1790347573 | Wilfred Shirley | Counselor | 1/2 Mile Northeast Dilkon Bashas Store, Winslow, AZ 86047 | 2019-07-02 |
| 1871055624 | Mark Ashcraft | Student in an Organized Health Care Education/Training Program | Winslow Indian Health Care Center, 500 North Indiana Ave, Winslow, AZ 86047 | 2019-04-02 |
| 1568928521 | Winslow Indian Health Care Center, Inc | Pharmacy | 1.5 Mile N. Leupp Chapter House, Leupp, AZ 86047 | 2019-02-14 |
| 1659837615 | Winslow Indian Health Care Center, Inc | Pharmacy | 3 Mls S. of Dilkon Chapter Hse., Dilkon, AZ 86047 | 2019-02-14 |
| 1750809836 | Grassroots Medical Supply | Durable Medical Equipment & Medical Supplies | Nec Navajo Route 15 and 60, Suite #2, Winlsow, AZ 86047 | 2017-09-08 |
| 1538697396 | Janell K Dickson | Counselor | 1/4 Mile Ne of Bashas, Dilkon, AZ 86047 | 2017-05-24 |
| 1235599143 | Dennis Peters | Veterinarian | 4301 W Highway 66, Winslow, AZ 86047 | 2016-03-04 |
| Find all providers in zip 86047 | ||||
| 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 |
|---|---|---|---|---|
| 1174058580 | Nathaniel B Johnson | Pharmacist | 24 Lithgow St, Winslow, ME 04901-7149 | 2017-04-23 |
| 1801140389 | Daniel Milovich | Pharmacist | 1601 N. Park Dr, Winslow, AZ 86024 | 2012-11-05 |
| 1780997189 | Sudhir Dabbas | Pharmacist | 36 China Rd, Winslow, ME 04901-7246 | 2010-07-14 |
| 1851555908 | Patricia Dee Wilke | Pharmacist | 2640 W Third St, Winslow, AZ 86047-2102 | 2008-07-17 |
| 1437149051 | Carmen Cirilo Clelland | Pharmacist | 333 W Mahoney St, Winslow, AZ 86047-2633 | 2005-10-25 |
| 1831704097 | Christopher Richard Nalepa | Pharmacist | 20 Garland Rd, Winslow, ME 04901-0600 | 2020-09-14 |
| 1033769302 | Brian Ma | Pharmacist | 500 N Indiana Ave, Winslow, AZ 86047-8604 | 2019-09-18 |
| 1932671377 | Ruth Choi | Pharmacist | 500 N Indiana Ave, Winslow, AZ 86047 | 2018-12-26 |
| 1447768676 | Brian Trinh | Pharmacist | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2018-01-22 |
| 1922515261 | Andrew Su | Pharmacist | 500 Indiana Ave, Winslow, AZ 86047-2169 | 2018-01-09 |
| Find all providers in WINSLOW | ||||
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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.