MR. BRIAN DAVID FONTAINE (NPI# 1366656753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366656753 |
| Entity Type | Individual |
| Full Name | MR. BRIAN DAVID FONTAINE |
| Credential | RPH |
| Practice Address |
125 Mascoma St Lebanon NH 03766-2647 |
| Mailing Address |
23 Grandview Ave Lebanon NH 03766-1870 |
| Practice Telephone | 6034487404 |
| Mailing Telephone | 6034489701 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
R1081 | NH | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588181515 | Brian Fontaine | Pharmacist | 271 Mammoth Rd, Manchester, NH 03109-4124 | 2017-08-30 |
| 1861584005 | Brian Kenneth Fontaine | Nurse Anesthetist, Certified Registered | 1400 Vfw Pkwy, West Roxbury, MA 02132-4927 | 2006-09-28 |
| Street Address |
125 MASCOMA ST |
| City | LEBANON |
| State | NH |
| Zip Code | 03766-2647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033105044 | Douglas A Deaett | Emergency Medicine | 125 Mascoma St, Lebanon, NH 03766-2647 | 2005-09-26 |
| 1104066547 | Paul Nicholas Vanloan | Emergency Medicine | 125 Mascoma St, Lebanon, NH 03766-2647 | 2009-02-25 |
| 1386821015 | Mircea Silviu Tamasdan | Internal Medicine | 125 Mascoma St, Lebanon, NH 03766-2647 | 2008-01-24 |
| 1285846907 | Jonathan Christopher Lee | Pharmacist | 125 Mascoma St, Lebanon, NH 03766-2647 | 2007-05-04 |
| 1497967020 | William Maloney | Pharmacist | 125 Mascoma St, Alice Peck Day Memorial Hospital, Lebanon, NH 03766-2647 | 2007-05-04 |
| 1104906619 | Valley Radiologists, P.a. | Radiology | 125 Mascoma St, Alice Peck Day Hospital, Lebanon, NH 03766-2647 | 2006-10-17 |
| 1275626863 | Morris Bol | Family Medicine | 125 Mascoma St, Lebanon, NH 03766 | 2006-10-02 |
| 1013920529 | Jayne M. Buckley | Pharmacist | 125 Mascoma St, Lebanon, NH 03766-2647 | 2006-08-14 |
| 1639137037 | Linda Sue Zoller-mckibbin | Physical Therapy Assistant | 125 Mascoma St, Alice Peck Day Hospital, Lebanon, NH 03766-2647 | 2006-05-03 |
| 1467437822 | Dennis W Coombs | Specialist | 125 Mascoma St, Lebanon, NH 03766-2647 | 2005-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033580345 | Leah E Abrahamsen | Social Worker | 85 Mechanic Street Suite 3b-1, Dartmouth Hitchcock - Psychiatry, Lebanon, NH 03766 | 2015-10-13 |
| 1871982801 | Steps Opioid Addiction Treatment | Clinic/Center | 1 Glen Road, Suite 216, Lebanon, NH 03766 | 2015-01-14 |
| 1811282288 | Lisa Golden Morse | Occupational Therapist | 23 Mahon St, Lebanon, NH 03766 | 2011-06-14 |
| 1750607131 | Timothy Joseph Lin | Orthopaedic Surgery | 1 Medical Center Drive Orthopaedics, Lebanon, NH 03766 | 2010-04-11 |
| 1457673857 | Melanie A Baker | Dental Hygienist | One Court Street, Suite 270, Lebanon, NH 03766 | 2010-02-26 |
| 1568613073 | Peter Keith Isquith | Clinical Neuropsychologist | 367 Route 120 Unit B1, Hanover Road Professional Center, Lebanon, NH 03766 | 2008-10-02 |
| 1235317512 | Leslie Sudak | Speech-Language Pathologist | 10 Mascoma St, Lebanon, NH 03766 | 2008-02-08 |
| 1891973269 | Dc Whitfield | Nurse Practitioner | 20 W Park St Ste 418, Lebanon, NH 03766 | 2008-02-07 |
| 1588879951 | Charles R Meyers | Acupuncturist | 2 Whipple Place, Lebanon, NH 03766 | 2007-05-11 |
| 1285859686 | Thomas A Johnston | Dentist | 206 Heater Road, Lebanon, NH 03766 | 2007-04-13 |
| Find all providers in zip 03766 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538407127 | Casey Paige Lewis | Pharmacist | 100 Physicians Way, Lebanon, TN 37090-8102 | 2013-01-16 |
| 1801124227 | Monica Marie Bowen | Pharmacist | 1700 S Lincoln Ave, Va Pharmacy Department (719), Lebanon, PA 17042-7529 | 2009-11-23 |
| 1811143175 | Louis John Portas Jr. | Pharmacist | 1700 S Lincoln Ave, Lebanon, PA 17042-7529 | 2008-08-18 |
| 1821287715 | Heather Ulrich | Pharmacist | 1700 S Lincoln Ave, Pharmacy, Bld. 17, Lebanon, PA 17042-7529 | 2007-10-17 |
| 1245424167 | Susan R Littlepage | Pharmacist | 1 Medical Center Dr, Dhmc Inpatient Pharmacy, Lebanon, NH 03756 | 2007-09-04 |
| 1265648901 | David Phillip Morge | Pharmacist | 1303 W Main St, Lebanon, TN 37087-3209 | 2007-05-16 |
| 1447467006 | Geoffrey A. Rickrode | Pharmacist | 1 Medical Center Dr, Pharmacy Department, Lebanon, NH 03756-1000 | 2007-05-16 |
| 1427264985 | Amanda Catherine Chuk | Pharmacist | 1 Medical Center Dr, Inpatient Pharmacy, Level 2, Lebanon, NH 03756-1000 | 2007-05-14 |
| 1700929502 | Cory M Rahn | Pharmacist | 525 N Santiam Hwy, Lebanon, OR 97355-4363 | 2007-02-14 |
| 1942318233 | Edwin Lee Caudill | Pharmacist | 1700 S Lincoln Ave, Lebanon, PA 17042-7529 | 2006-08-27 |
| Find all providers in LEBANON | ||||
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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.