MR. DANIEL JAMES GUSTIN (NPI# 1497061352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497061352 |
| Entity Type | Individual |
| Full Name | MR. DANIEL JAMES GUSTIN |
| Credential | PHARM D |
| Practice Address |
1109 Lombardi Ave Green Bay WI 54304 |
| Practice Telephone | 9204996004 |
| Practice Fax Number | 9204997959 |
| Mailing Telephone | 9204996004 |
| Mailing Fax Number | 9204997959 |
| Enumeration Date | 2010-08-28 |
| Last Update Date | 2013-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 15396-40 | WI | Pharmacy Service Providers |
| Street Address |
1109 LOMBARDI AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699706739 | K Mart Corp | Pharmacy | 1109 Lombardi Ave, Green Bay, WI 54304 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| 1609069608 | Linda Marie Socker | Occupational Therapist | 812 S Fisk Street, Suite 109, Green Bay, WI 54304 | 2007-08-22 |
| Find all providers in zip 54304 | ||||
| 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 |
|---|---|---|---|---|
| 1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
| 1396119236 | Nicole Marie Schreiner | Pharmacist | 2519 Clear Brook Cir, Green Bay, WI 54313-3997 | 2015-11-16 |
| 1265860068 | Ellen Ladowski | Pharmacist | 2786 Candle Ln, Green Bay, WI 54304-1662 | 2013-10-15 |
| 1164869038 | Jean Marie Richardson | Pharmacist | 3030 Grande Rue, Green Bay, WI 54301 | 2013-05-31 |
| 1861746018 | Lynn Marie Knute | Pharmacist | 1230 Western Meadows Dr, Green Bay, WI 54313-1324 | 2012-11-08 |
| 1114294311 | Jill Anne Guernsey | Pharmacist | 2301 S. Oneida St, Green Bay, WI 54301 | 2011-11-17 |
| 1245516293 | Jennifer Bromberek | Pharmacist | 2566 Johnny Ln, Green Bay, WI 54311-4412 | 2011-10-21 |
| 1902181035 | Laura Sewall | Pharmacist | 1150 Springhurst Dr, Suite #206, Green Bay, WI 54304-5950 | 2011-10-20 |
| 1871707141 | Robert J Atkinson | Pharmacist | 1478 Parkway Dr, Green Bay, WI 54304-1975 | 2007-05-09 |
| 1518903889 | Mary-clare Piontek | Pharmacist | 744 South Webster Ave, Green Bay, WI 54305-3400 | 2006-06-22 |
| Find all providers in GREEN BAY | ||||
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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.