DR. SUSAN M MAHONEY-WEBER (NPI# 1396177259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396177259 |
| Entity Type | Individual |
| Full Name | DR. SUSAN M MAHONEY-WEBER |
| Credential | PHARMD RPH |
| Practice Address |
706 38th St Nw Ste Def Fargo ND 58102-2953 |
| Practice Telephone | 7018939050 |
| Practice Fax Number | 8003402621 |
| Mailing Telephone | 7014929196 |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-08-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
ND 4753 | ND | Pharmacy Service Providers |
| Street Address |
706 38TH ST NW STE DEF |
| City | FARGO |
| State | ND |
| Zip Code | 58102-2953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710311675 | Jessica Ann Dietz | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2013-08-28 |
| 1528372596 | Patrick Jon Netland | Pharmacist | 2101 Elm St N, 119 Pharmacy, Fargo, ND 58102-2417 | 2010-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225373798 | Zachary John Marty | Pharmacist | 213 3rd St Ne, Rolla, ND 58367-7140 | 2012-12-10 |
| 1760025753 | Zyonne Theo Servo Arcena | Pharmacist | 1300 Hospital Loop, Belcourt, ND 58316 | 2019-10-22 |
| 1174097364 | Brian Ament | Pharmacist | 2422 20th St Sw, Jamestown, ND 58401-6201 | 2019-01-22 |
| 1447746177 | Erik Michael Nelson | Pharmacist | 3101 N 11th St, Bismarck, ND 58503-0594 | 2018-07-05 |
Please comment or provide details below to improve the information on DR. SUSAN M MAHONEY-WEBER.
| 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.