GREGORY BODENHEIMER (NPI# 1013486455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013486455 |
| Entity Type | Individual |
| Full Name | GREGORY BODENHEIMER |
| Credential | PHARMD |
| Practice Address |
5322 Us Highway 158 Advance NC 27006-6907 |
| Mailing Address |
1440 Noahtown Rd Thomasville NC 27360-0716 |
| Practice Telephone | 3369405515 |
| Mailing Telephone | 3364423726 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 28111 | NC | Pharmacy Service Providers |
| Street Address |
5322 US HIGHWAY 158 |
| City | ADVANCE |
| State | NC |
| Zip Code | 27006-6907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598988503 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5322 Us Highway 158, Advance, NC 27006-6907 | 2007-04-10 |
| 1861018871 | Mandi Marissa Sumners | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2020-06-25 |
| 1588216113 | Deepti Pidakala | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2019-07-13 |
| 1558818344 | Deema Alazmeh | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2016-09-08 |
| 1891101028 | Morgan Costner | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2014-07-08 |
| 1467708701 | Dianna Choua Lee | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2012-07-24 |
| 1316247430 | Thomas Dustin Hayes | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2010-10-22 |
| 1669793543 | Jessica Brooks Mcduffie | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2010-06-15 |
| 1972834927 | Roxanne Marie Yankee | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2010-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811567 | Venessa Brunt | Home Health | 271 Orchard Park Drive, Advance, NC 27006 | 2020-08-17 |
| 1730707928 | Dara Elzena Green | Physical Therapist | 142 Hollybrook Dr, Advance, NC 27006 | 2020-07-14 |
| 1104339084 | Mark Curry Maynard | Registered Nurse | 125 W Robin Dr, Advance, NC 27006 | 2017-11-14 |
| 1457781585 | Christa Cook | Physical Therapist | 316 N Carolina 801, Advance, NC 27006 | 2013-11-27 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1073745485 | Digestive Health Specialists, Pa | Internal Medicine | 112 Kinderton Blvd, Advance, NC 27006 | 2009-08-18 |
| 1114101078 | Dr. Todd Carter D.d.s | Dentist | 123 Nc Highway 801 S. #c-100, Advance, NC 27006 | 2007-12-27 |
| 1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
| 1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
| 1104927987 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 260 Highway 801, Advance, NC 27006 | 2006-09-26 |
| Find all providers in zip 27006 | ||||
| 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 |
|---|---|---|---|---|
| 1639650849 | Jodi Crader | Pharmacist | 411 Osage Dr, Advance, MO 63730-8062 | 2018-08-25 |
| 1396021994 | Mark Howard Holshouser | Pharmacist | 1510 Nc Highway 801 N, Advance, NC 27006-6704 | 2011-10-26 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1356574057 | Louis Johnston Utsey | Pharmacist | 260 Nc Highway 801 N, Advance, NC 27006-7944 | 2009-08-27 |
| 1861018871 | Mandi Marissa Sumners | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2020-06-25 |
| 1588216113 | Deepti Pidakala | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2019-07-13 |
| 1558818344 | Deema Alazmeh | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2016-09-08 |
| 1891101028 | Morgan Costner | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2014-07-08 |
| 1003164278 | Allison Griffin | Pharmacist | 110 Nc Highway 801 N, Advance, NC 27006-7943 | 2012-08-20 |
| 1467708701 | Dianna Choua Lee | Pharmacist | 5322 Us Highway 158, Advance, NC 27006-6907 | 2012-07-24 |
| Find all providers in ADVANCE | ||||
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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.