DR. VINCENT EUGENE JACKSON (NPI# 1710985783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710985783 |
| Entity Type | Individual |
| Full Name | DR. VINCENT EUGENE JACKSON |
| Credential | PHARM D, RPH |
| Practice Address |
100 Hospital Rd Pharmacy Department Prince Frederick MD 20678-4017 |
| Mailing Address |
345 Madeline Dr St Leonard MD 20685-2567 |
| Practice Telephone | 4105354000 |
| Practice Fax Number | 4105358307 |
| Mailing Telephone | 3015803818 |
| Mailing Fax Number | 4105358307 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
15453 | MD | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801202635 | Vincent Maurice Jackson Sr. | Behavioral Analyst | 875 Mass Ave Unit 205, Indianapolis, IN 46204-1652 | 2014-07-01 |
| 1033471669 | Vincent Paul Jackson | Radiologic Technologist | 4950 Glaze Dr, Atlanta, GA 30360-1702 | 2012-06-11 |
| 1255332003 | Vincent A Jackson | Nurse Anesthetist, Certified Registered | 3601 Tvc, Nashville, TN 37232-0001 | 2005-08-02 |
| Street Address |
100 HOSPITAL RD PHARMACY DEPARTMENT |
| City | PRINCE FREDERICK |
| State | MD |
| Zip Code | 20678-4017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162489 | Paul Ejime Iweriebor | Nurse Practitioner | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2020-04-08 |
| 1235765629 | Elias Ngang Warah | Nurse Anesthetist, Certified Registered | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2020-03-17 |
| 1780221663 | Elizabeth Anne Wall | Physical Therapist | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2019-12-10 |
| 1790248649 | Nastassia Morgan Hawkins | Nurse Anesthetist, Certified Registered | 100 Hospital Rd, Department of Anesthesia, Prince Frederick, MD 20678-4017 | 2019-04-08 |
| 1902384258 | Upeksha Sewwandi Thilakawardana | Nurse Practitioner | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2018-07-30 |
| 1003311002 | Luis Antonio Velazquez | Nurse Anesthetist, Certified Registered | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2018-03-29 |
| 1598276826 | Stephanie Steinhoff | Hospitalist | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2017-10-13 |
| 1689190514 | Catina Stefanik | Social Worker | 100 Hospital Rd, Prince Frederick, MD 20678 | 2017-08-22 |
| 1740730274 | Calvert Pathology LLC | Pathology | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2016-10-07 |
| 1881040764 | Natasha Bates | Registered Nurse | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2016-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861857500 | Watershed Counseling Service | Counselor | 246 Merrimac Court, Prince Frederick, MD 20678 | 2015-12-23 |
| 1023449642 | Mary Gordon Walter | Registered Nurse | 976 Solomans Island Road, Prince Frederick, MD 20678 | 2013-12-07 |
| 1891126827 | Jacqueline Leclercq | Nurse Practitioner | 110 Hospital Road Suite 303, Prince Frederick, MD 20678 | 2013-12-02 |
| 1174959001 | Linsey Rowe Heane | Physical Therapist | 110 Main Street Suite 1, Prince Frederick, MD 20678 | 2013-09-24 |
| 1053607002 | Tidewater Dental Pf | Dentist | 690 Prince Frederick Blvd, Prince Frederick, MD 20678 | 2011-06-28 |
| 1033411558 | Sharon Patricia Parran | Pharmacist | 80 W.dares Beach Road, Prince Frederick, MD 20678 | 2010-12-04 |
| 1366684326 | Prince Frederick Surgery Center LLC | Clinic/Center | 70 Sherry Lane, Suite 101, Prince Frederick, MD 20678 | 2009-04-06 |
| 1982844734 | Orthocare Solutions Inc | Durable Medical Equipment & Medical Supplies | 220 Old Solomans Island Rd, Prince Frederick, MD 20678 | 2009-03-05 |
| 1225273519 | Rebecca Lynn Jahed | Audiologist | 3180 Blackberry Lane, Prince Frederick, MD 20678 | 2008-12-16 |
| 1669639209 | Ralph Walter Niemann | Dentist | 272 Merrimac Court, Prince Frederick, MD 20678 | 2008-05-21 |
| Find all providers in zip 20678 | ||||
| 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 |
|---|---|---|---|---|
| 1750821302 | Priscilla Dede Azu | Pharmacist | 355 Market Square Dr, Prince Frederick, MD 20678-3173 | 2017-03-01 |
| 1538167655 | Kara A Harrer | Pharmacist | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2005-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851911754 | Seferina Kim | Pharmacist | 16 S Eutaw St Ste 200, Baltimore, MD 21201-1626 | 2020-04-21 |
| 1598384992 | Lindsay Wagner | Pharmacist | 10001 New Hampshire Ave Fl 4, Silver Spring, MD 20903-1707 | 2020-04-15 |
| 1871122663 | Kofi Jantuah | Pharmacist | 8306 Finchleigh St, Laurel, MD 20724-1973 | 2020-04-03 |
| 1023543147 | Kevin Albert Schnupp | Pharmacist | 1025 Wagner Rd, Towson, MD 21204-6821 | 2017-04-26 |
| 1790225704 | Sylvia Best | Pharmacist | 8901 Wisconsin Avenue Wrnmmc-, Americas Building 19- Internal Medicine Suite 2820, Bethesda, MD 20889 | 2017-02-24 |
| 1699210096 | Mary Jay Taylor | Pharmacist | 4861 Atlas Cedar Way, Aberdeen, MD 21001-5602 | 2016-12-21 |
| 1063860146 | Oyetola Olufidipe | Pharmacist | 5485 Glenthorne Ct, Rosedale, MD 21237-2202 | 2016-05-30 |
| 1164838835 | Chris Muskelly | Pharmacist | 8108 Arbor View Way, Elkridge, MD 21075-6483 | 2014-07-02 |
| 1891125787 | Dominick Memoli | Pharmacist | 17972 Dumfries Cir, Olney, MD 20832-1647 | 2013-11-14 |
| 1295169464 | Sankung Sise | Pharmacist | 8210 Red Gate Ct, Bowie, MD 20715-3368 | 2013-08-23 |
| Find all providers with the same taxonomy | ||||
| City | PRINCE FREDERICK |
| Zip Code | 20678 |
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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.