AMANDEEP MATHARU (NPI# 1104202548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104202548 |
| Entity Type | Individual |
| Full Name | AMANDEEP MATHARU |
| Practice Address |
2301 Hall Ave Marinette WI 54143-1236 |
| Mailing Address |
1423 S Collins St Plant City FL 33563-6577 |
| Practice Telephone | 7157324102 |
| Practice Fax Number | 7157324518 |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2020-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 19207-40 | WI | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | PS53824 | FL | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1423 S Collins St, Plant City, FL 335636577 | 8137521133 |
| Street Address |
2301 HALL AVE |
| City | MARINETTE |
| State | WI |
| Zip Code | 54143-1236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972518058 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2301 Hall Ave, Marinette, WI 54143-1236 | 2006-07-29 |
| 1376828350 | Eric Risner | Pharmacist | 2301 Hall Ave, Marinette, WI 54143-1236 | 2011-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669966750 | Allie Parthie | Dentist | 1420 University Dr, Marinette, WI 54143 | 2018-06-21 |
| 1043730690 | Jonathan Weseman | Emergency Medicine | 3003 University Dr, Marinette, Marinette, WI 54143 | 2017-06-25 |
| 1538698618 | Meghan M Russell | Nurse Practitioner | 4061 Old Peshtigo Road, Marinette, WI 54143 | 2017-06-12 |
| 1801279435 | Stephanie Miller | Licensed Practical Nurse | W1902 State Hwy 64, Marinette, WI 54143 | 2015-07-01 |
| 1417298704 | Danielle Risner | Occupational Therapist | Luther Home 831 Pine Beach Rd, Marinette, WI 54143 | 2013-03-12 |
| 1053631903 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | W 716 County B, Ste B, Marinette, WI 54143 | 2010-06-02 |
| 1417105545 | Forefront Dermatology, S.c. | Dermatology | 3515 Murray Street, Marinette, WI 54143 | 2008-09-03 |
| 1245493352 | Judith M Ribbens | Counselor | 1557 Cleveland Ave, Marinette, WI 54143 | 2008-07-08 |
| 1538338926 | Charlene Mae Miller | Licensed Practical Nurse | 1126 Daggett, Marinette, WI 54143 | 2008-02-29 |
| 1104025519 | James Alan Boren | Family Medicine | 5926 Highway 41, Stephenson, MI 54143 | 2007-07-16 |
| Find all providers in zip 54143 | ||||
| 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 |
|---|---|---|---|---|
| 1982641965 | Hayward Anderson | Pharmacist | 1435 Main St, Marinette, WI 54143-2415 | 2006-05-31 |
| 1790385128 | Raymond Arthur Smith | Pharmacist | 2900 Roosevelt Rd, Marinette, WI 54143-4299 | 2020-10-26 |
| 1134728470 | Hannah Turner | Pharmacist | 2900 Roosevelt Rd, Pharmacy, Marinette, WI 54143 | 2020-10-19 |
| 1619410628 | Sarah O'connor | Pharmacist | 2820 Roosevelt Rd, Marinette, WI 54143 | 2016-11-22 |
| 1164858023 | Nicole Ann Conklin | Pharmacist | 2741 Roosevelt Rd, Marinette, WI 54143-3833 | 2013-09-23 |
| 1477991875 | James William Bosch | Pharmacist | 2741 Roosevelt Rd, Marinette, WI 54143-3833 | 2013-06-06 |
| 1780928846 | Natalie Ann Oberdorfer | Pharmacist | 4061 Old Peshtigo Rd, Marinette, WI 54143-3887 | 2012-11-15 |
| 1508100645 | Neil Gary Tuthill | Pharmacist | 4061 Old Peshtigo Rd, Marinette, WI 54143-3887 | 2012-11-15 |
| 1194079236 | Michele Panske | Pharmacist | 2741 Roosevelt Rd, Marinette, WI 54143-3833 | 2012-10-26 |
| 1881967792 | Lisa Marie Pardee | Pharmacist | 1435 Main St, Marinette, WI 54143-2415 | 2012-02-23 |
| Find all providers in MARINETTE | ||||
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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.