CALEB DAVID BRAASCH (NPI# 1053927988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053927988 |
| Entity Type | Individual |
| Full Name | CALEB DAVID BRAASCH |
| Practice Address |
1818 South Airport Rd Decatur IL 62521 |
| Mailing Address |
1818 South Airport Road Decatur IL 62521 |
| Practice Telephone | 2178645912 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
051303293 | IL | Pharmacy Service Providers |
| Street Address |
1818 SOUTH AIRPORT RD |
| City | DECATUR |
| State | IL |
| Zip Code | 62521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| 1275781593 | Deborah Deloney | Speech-Language Pathologist | Fairhaven Christian Home, 1790 South Fairview, Decatur, IL 62521 | 2008-08-28 |
| Find all providers in zip 62521 | ||||
| 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 |
|---|---|---|---|---|
| 1598320822 | Steven Maddox | Pharmacist | 800 Suite A Medical Center Dr, Decatur, TX 76234-7623 | 2019-05-02 |
| 1457693632 | Jasper W Watkins IIi | Pharmacist | 1670 Clairmont Rd # 119, Decatur, GA 30033-4004 | 2013-03-26 |
| 1932488293 | Chanel Ryan | Pharmacist | 3088 Lauren Parc Rd, Decatur, GA 30032-3632 | 2011-08-04 |
| 1154921211 | Vinay Soni | Pharmacist | 4224 N Prospect Dr, Decatur, IL 62526-6100 | 2020-10-28 |
| 1083213086 | Catherine Richardson | Pharmacist | 4915 Flat Shoals Pkwy, Decatur, GA 30034-5210 | 2020-10-21 |
| 1376141093 | Mercy E Uzor | Pharmacist | 4915 Flat Shoals Pkwy, Decatur, GA 30034-5210 | 2020-10-14 |
| 1093342404 | Abigail Rose Lewis | Pharmacist | 2875 N Decatur Rd, Decatur, GA 30033-5911 | 2020-03-25 |
| 1033743000 | Asefa Teferra | Pharmacist | 2385 Wesley Chapel Rd, Decatur, GA 30035-2803 | 2020-02-27 |
| 1487287025 | Allyson Lynnae Anglin | Pharmacist | 3479 Memorial Dr, Decatur, GA 30032-2735 | 2020-02-21 |
| 1629608930 | Elaine Brown-mcrae | Pharmacist | 2385 Wesley Chapel Rd, Decatur, GA 30035-2803 | 2020-01-26 |
| Find all providers in DECATUR | ||||
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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.