SAMUEL VANG (NPI# 1770915464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770915464 |
| Entity Type | Individual |
| Full Name | SAMUEL VANG |
| Credential | RPH. |
| Practice Address |
5300 Memorial Dr Suite 103 Two Rivers WI 54241-3923 |
| Practice Telephone | 9207937380 |
| Practice Fax Number | 9207937381 |
| Mailing Telephone | 9207937380 |
| Mailing Fax Number | 9207937381 |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 13748-40 | WI | Pharmacy Service Providers |
| Street Address |
5300 MEMORIAL DR SUITE 103 |
| City | TWO RIVERS |
| State | WI |
| Zip Code | 54241-3923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215913207 | Phyllis Kasper | Psychologist | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2005-12-21 |
| 1487282802 | Jane B Bersch | Massage Therapist | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2020-03-31 |
| 1952938334 | Sara Wendt | Massage Therapist | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2020-03-25 |
| 1689156481 | Tyler Luedtke | Physical Therapist | 5300 Memorial Dr, Two Rivers, WI 54241 | 2018-08-29 |
| 1376037499 | Julie Brunner | Registered Nurse | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2018-06-21 |
| 1356838049 | Rachel Marie Geiger | Occupational Therapist | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2018-04-18 |
| 1740781715 | Lindsey Shea Herman | Occupational Therapist | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2018-02-26 |
| 1659898385 | Sandra R Van Groll | Nurse Practitioner | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2017-08-23 |
| 1821513136 | Kevin Kornowski | Physician Assistant | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2017-08-08 |
| 1336676360 | Pamela J Masci | Social Worker | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2017-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629617667 | Karrie May Kudrna Behrent | Counselor | Phoenix Behavioral Health Services LLC, 3120 Memorial Dr., Two Rivers, WI 54241 | 2019-12-21 |
| 1972147460 | Linda Sand | Technician | 11409 Wedge Dr., Two Rivers, WI 54241 | 2019-10-29 |
| 1710536446 | Margaret Smith | Technician | 1916 Roosevelt Ave, Two Rivers, WI 54241 | 2019-09-05 |
| 1770967572 | Baycare Clinic LLP | Ophthalmology | 1603 Washington Street, Two Rivers, WI 54241 | 2015-07-13 |
| 1194091322 | Fisher Chiropractic and Rehab Center LLC | Chiropractor | 1817 Washington Street, Two Rivers, WI 54241 | 2012-04-02 |
| 1396075016 | Holly Lynn Struck | Physical Therapist | 5300 Memorial Drive, Two Rivers, WI 54241 | 2009-12-31 |
| 1558451906 | David James Loritz | Dentist | 1413 22nd St, Two Rivers, WI 54241 | 2006-10-14 |
| 1598737744 | City of Two Rivers | Ambulance | 2122 Monroe St, Two Rivers, WI 54241 | 2006-02-02 |
| 1912426925 | Amy C Nowak | Nurse Practitioner | 2219 Garfield St, Two Rivers, WI 54241 | 2017-09-12 |
| 1710367123 | Matthew J Hobbins | Internal Medicine | 5000 Memorial Dr, Two Rivers, WI 54241 | 2015-06-02 |
| Find all providers in zip 54241 | ||||
| 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 |
|---|---|---|---|---|
| 1194823385 | Brian Charles Jensen | Pharmacist | 2012 Crystal Spring Rd, Two Rivers, WI 54241-9368 | 2006-09-20 |
| 1023008166 | Marvin Robert Moore | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2005-10-27 |
| 1548868771 | Kaytlyn Rae Kramer Dummer | Pharmacist | 2206 Washington St, Two Rivers, WI 54241-2241 | 2020-10-09 |
| 1831723162 | Jay Urban | Pharmacist | 2206 Washington St, Two Rivers, WI 54241-2241 | 2020-02-25 |
| 1376198739 | Catherine Tolar | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2019-08-02 |
| 1730662180 | Alan Michael Duvall | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2018-09-12 |
| 1053868380 | Tucker J Stewart | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2016-09-02 |
| 1104202050 | Mackenzie Nigl | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2015-08-03 |
| 1831506237 | Bryant Schobert | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2014-07-17 |
| 1396185724 | Katie Lynn Schroeder | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2013-06-29 |
| Find all providers in TWO RIVERS | ||||
| City | TWO RIVERS |
| Zip Code | 54241 |
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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.