DR. MARY ANTOINETTEE ROACH (NPI# 1417465311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417465311 |
| Entity Type | Individual |
| Full Name | DR. MARY ANTOINETTEE ROACH |
| Credential | PHARMD |
| Practice Address |
12001 Autumnwood Ln Fort Washington MD 20744-6065 |
| Practice Telephone | 3012547656 |
| Mailing Telephone | 3012547656 |
| Enumeration Date | 2018-01-14 |
| Last Update Date | 2018-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | PHA3183 | DC | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PHA3183 | DC | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437281375 | Mary Susan Roach | Nurse Practitioner | 703 N. 1st Street, Mccall, ID 83638-3851 | 2007-03-09 |
| 1558378521 | Mary Roach | Nurse Practitioner | 2211 Lomas Blvd, Ne, Unm Hospitals, Albuquerque, NM 87106 | 2006-08-02 |
| 1447723978 | Mary Theresa Roach | Behavior Technician | 5 Revere Dr Ste 120, Northbrook, IL 60062-8005 | 2019-01-08 |
| 1053801779 | Mary Kathleen Roach | Nurse Practitioner | 200 E Chestnut St, Louisville, KY 40202-1831 | 2018-05-17 |
| Street Address |
12001 AUTUMNWOOD LN |
| City | FORT WASHINGTON |
| State | MD |
| Zip Code | 20744-6065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558823807 | Sybil Canales | Nurse Practitioner | 8507 Oxon Hill Rd., Suite 200, Fort Washington, MD 20744 | 2019-04-04 |
| 1700372141 | Avia Barrett-powell | Nurse Practitioner | 10709 Md-210 Suite D, Fort Wasshington, MD 20744 | 2018-07-09 |
| 1285125047 | Darlene Williams-prades | Specialist | 9400 Livingston Rd Ste 400, Ft Washington, MD 20744 | 2018-05-28 |
| 1609371277 | My Girl's Place Pllc | Social Worker | 8507 Oxon Hill Rd Ste 200-s35, Fort Washington, MD 20744 | 2018-03-27 |
| 1720580293 | Janet C Nwaogu | Licensed Practical Nurse | 6856 Eastern Avenue Suite 320 A, Washington (and Vicinity), MD 20744 | 2018-03-01 |
| 1174040505 | Sharon Ray | Specialist | 12303 Parkton St, Fort Washington, MD 20744 | 2017-08-25 |
| 1013433069 | Carmilla Wheeler | Specialist/Technologist | 12515 Langner Drive, Fort Washington, MD 20744 | 2017-08-21 |
| 1194266627 | Brian Cooper I | Home Health Aide | 9008 Branchview Dr, Fort Washington, MD 20744 | 2017-03-16 |
| 1467803973 | Saint Pharmacy, Inc | Pharmacy | 5608 Saint Barnabas Road, Suite 120, Fort Washington, MD 20744 | 2016-06-27 |
| 1962802959 | Eric Fosung Fotang | Pharmacist | 8201 Oxon Hill Road, Fort Washington, MD 20744 | 2014-08-27 |
| Find all providers in zip 20744 | ||||
| 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 |
|---|---|---|---|---|
| 1720697436 | Maxcare Pharmacy | Pharmacist | 7448 Baltimore Annapolis Blvd Ste A, Glen Burnie, MD 21061-3468 | 2020-07-28 |
| 1255966735 | David Lee Lowery | Pharmacist | 1102 Midvale Ave, Mount Airy, MD 21771-5522 | 2020-03-05 |
| 1639703523 | Mary Katherine Emadi | Pharmacist | 1320 Londontown Blvd, Eldersburg, MD 21784-6409 | 2020-02-28 |
| 1245878875 | Crowns Pharmacy LLC | Pharmacist | 9705 Fort Meade Rd, Laurel, MD 20707-4405 | 2019-12-13 |
| 1932750536 | Oluwadamilola Ademiluyi | Pharmacist | 202 Bottsford Ave, Upper Marlboro, MD 20774-8416 | 2019-09-25 |
| 1093361008 | Mark Adjetey | Pharmacist | 18924 Marsh Hawk Ln, Gaithersburg, MD 20879-1774 | 2019-08-15 |
| 1841760048 | Roudabeh Faghri | Pharmacist | 1201 Dutchmans Creek Dr, Brunswick, MD 21716-9770 | 2018-11-29 |
| 1003384678 | Prime Clinical Associates, LLC | Pharmacist | 9019 Sunni Shade Ct, Perry Hall, MD 21128-9222 | 2018-11-12 |
| 1922594837 | Adebayo Ajifolokun | Pharmacist | 2307 Clerklee Way, Bowie, MD 20721-1866 | 2018-07-03 |
| 1669993606 | Maria Giannas | Pharmacist | 6510 O'donnell St, Baltimore, MD 21224 | 2017-06-29 |
| Find all providers with the same taxonomy | ||||
| City | FORT WASHINGTON |
| Zip Code | 20744 |
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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.