BRENT TACKITT (NPI# 1063833127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063833127 |
Entity Type | Individual |
Full Name | BRENT TACKITT |
Credential | PHARMD |
Practice Address |
1768 Winding Glen Dr Saint Charles MO 63303-5099 |
Practice Telephone | 6182928476 |
Mailing Telephone | 6182928476 |
Enumeration Date | 2013-12-16 |
Last Update Date | 2013-12-16 |
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 |
2008029231 | MO | Pharmacy Service Providers |
Street Address |
1768 WINDING GLEN DR |
City | SAINT CHARLES |
State | MO |
Zip Code | 63303-5099 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083214787 | Michael Frederick | Pharmacist | 2855 Veterans Memorial Parkway, (pharmacy), Saint Charles, MO 63303 | 2020-10-30 |
1710525639 | Cheryl Ann O'dell | Pharmacist | Schnucks Pharmacy, 60 Harvester Square, St Charles, MO 63303 | 2019-12-11 |
1255821302 | Melinda R Winfield | Nurse Practitioner | 1313 Park Ct, Saint Charles, MO 63303 | 2018-05-15 |
1467904839 | Heather Lilledahl | Speech-Language Pathologist | 2800 Old Muegge Road, Saint Charles, MO 63303 | 2016-11-01 |
1437608312 | Preferred Family Healthcare | Counselor | 1559 Old S. River Road, St.charles, MO 63303 | 2016-10-03 |
1487109146 | Annette Patricia Davenport | Nurse Practitioner | 1551 Wall Street, Logistics Health Inc, Suite 100, Saint Charles, MO 63303 | 2016-08-23 |
1053762328 | Sarah Biondo | Speech-Language Pathologist | 7204 Fountainview Circle, Ofallon, MO 63303 | 2016-06-28 |
1710331335 | Lindsey Ann Eilers | Counselor | 1570 South Main, Saint Charles, MO 63303 | 2016-04-20 |
1174914600 | Jacquelyn Michele Miller | Pharmacy Technician | 3881 Mexico Road, Saint Charles, MO 63303 | 2015-02-05 |
1164838132 | Francelle Denise Neal | Counselor | 2480 Executive Dr Ste 111, Saint Charles, MO 63303 | 2014-07-10 |
Find all providers in zip 63303 |
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 |
---|---|---|---|---|
1992020333 | Alan William Seaton Jr. | Pharmacist | 484 Fortress Ct, Saint Charles, MO 63303-3892 | 2010-03-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
1538647250 | Brian D Davis | Pharmacist | 600 Winding Oaks Pl, Ballwin, MO 63021-7379 | 2018-08-03 |
1144718313 | Eddy Airiohuodion | Pharmacist | 8629 E Utopia Pkwy Apt 11, Raytown, MO 64138-5307 | 2018-04-24 |
1770085987 | Brigid Farrar | Pharmacist | 440 E Tampa St # 100, Springfield, MO 65806-1131 | 2018-03-03 |
1104347277 | Blake William Baumann | Pharmacist | 2301 Homes St, Kansas City, MO 64108 | 2017-06-29 |
1497280523 | Scott Strassels | Pharmacist | 8002 Davis Dr, Clayton, MO 63105-2529 | 2017-04-26 |
1942682604 | Shane Austin | Pharmacist | 8660 Old Bonhomme Rd Apt B, Saint Louis, MO 63132-3936 | 2015-06-18 |
1255735015 | Surendra R Patel | Pharmacist | 333 Solar Terrace Ct, Chesterfield, MO 63017-2499 | 2014-10-22 |
1093131500 | Chessa Nyberg | Pharmacist | 410 E Porte Cimi Pas St, Kansas City, MO 64131-2922 | 2014-03-07 |
1619319639 | Michael J. Cox | Pharmacist | 420 Wiltshire Dr, Raymore, MO 64083-7816 | 2013-07-18 |
Find all providers with the same taxonomy |
City | SAINT CHARLES |
Zip Code | 63303 |
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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.