MS. CHANTHEARA LONG (NPI# 1619499910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619499910 |
| Entity Type | Individual |
| Full Name | MS. CHANTHEARA LONG |
| Credential | PHARMD |
| Practice Address |
1 Va Ctr Augusta ME 04330-6719 |
| Mailing Address |
2 Choate Ln Apt 205 Hallowell ME 04347-1735 |
| Practice Telephone | 2076238411 |
| Enumeration Date | 2017-07-09 |
| Last Update Date | 2017-07-09 |
| 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 |
PH236555 | MA | Pharmacy Service Providers |
| Street Address |
1 VA CTR |
| City | AUGUSTA |
| State | ME |
| Zip Code | 04330-6719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437135704 | Nancy Louise Johnson | Counselor | 1 Va Ctr, Building 206, Augusta, ME 04330-6719 | 2005-12-19 |
| 1730789710 | Monica Rachel Lee | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-10-28 |
| 1336746841 | Danae E. Stuart | Nurse Practitioner | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-10-07 |
| 1699380774 | Erica Wolfe | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-09-15 |
| 1790303436 | Danny Sarkis | Student in an Organized Health Care Education/Training Program | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-07-09 |
| 1518585256 | Elizabeth Sullivan | Student in an Organized Health Care Education/Training Program | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-07-09 |
| 1710504907 | Katie S Eastman | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-07-03 |
| 1548885429 | Rebecca Labonte | Dietitian, Registered | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-06-16 |
| 1942824362 | Whitney C Sargent | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6795 | 2020-06-01 |
| 1336785708 | Matthew Douglas Campbell | Physician Assistant | 1 Va Ctr, Augusta, ME 04330-6719 | 2019-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181877 | Renewal Family Center, LLC | Community/Behavioral Health | 10 Learners Drive, Augusta, ME 04330 | 2020-10-12 |
| 1134748759 | Chelsea Simone Koch | Registered Nurse | 1 Va Center, Department of Veterans Affairs, Augusta, ME 04330 | 2020-04-14 |
| 1790238442 | Nicole Lacrosse | Behavioral Analyst | 53 Hayden Rd, Augusta, ME 04330 | 2016-07-29 |
| 1093176844 | Richard J. Larrabee | Counselor | 312 Townhouse Road, Chelsea, ME 04330 | 2016-03-08 |
| 1376910984 | Sarah C. A. Tatlock | Social Worker | 41 Anthony Ave, Augusta, ME 04330 | 2015-08-31 |
| 1457728180 | Va Maine Health | General Acute Care Hospital | 1 Va Center 05, Va Maine Healthcare System-togus, Augusta, ME 04330 | 2015-08-28 |
| 1043696842 | Megan Arsenault | Pharmacist | 403 Water Street, Augusta, ME 04330 | 2015-08-04 |
| 1205219987 | Trevor Holbert | Audiologist | 1 Va Center - Togus Va Medical Center, Audiology 126a, Augusta, ME 04330 | 2015-06-30 |
| 1659787836 | Hannah M. Pullen | Occupational Therapy Assistant | 12 Shuman Ave Ste 16, Augusta, ME 04330 | 2014-07-08 |
| 1831469899 | Tanya Bernadette Quarterman | Specialist | 153 Hospital St Ste 13, Augusta, ME 04330 | 2012-01-09 |
| Find all providers in zip 04330 | ||||
| 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 |
|---|---|---|---|---|
| 1316276033 | Susan Christine Fagan | Pharmacist | Hm 1220 1120 15th Street, University of Georgia College of Pharmacy, Augusta, GA 30912 | 2009-12-08 |
| 1609491281 | Melinda Kezer Drylie | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-10 |
| 1669009619 | Dalton Nuse | Pharmacist | 1510 Ohio St, Augusta, KS 67010-2189 | 2020-03-26 |
| 1740787472 | Katherine Donnan | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2018-04-09 |
| 1396244034 | Reid Wallace Griffin | Pharmacist | 1537 Walton Way, Augusta, GA 30904-3764 | 2018-02-08 |
| 1457726663 | Sudharsan Periyasamy Thandavan | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2015-12-14 |
| 1902274921 | Anishka Walker | Pharmacist | 950 15th St, Charlie Norwood Vamc - Pharmacy Department, Augusta, GA 30901-2608 | 2015-09-08 |
| 1073992020 | Kathleen Cleary | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2015-05-22 |
| 1477946531 | Amber Ladak | Pharmacist | 1120 15th St, Augusta, GA 30912-0004 | 2015-03-13 |
| 1699165548 | Tim Robinson | Pharmacist | 1120 15th St, Bi-2101, Augusta, GA 30912-0004 | 2015-01-30 |
| Find all providers in AUGUSTA | ||||
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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.