JESSICA MORENO (NPI# 1164991782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164991782 |
| Entity Type | Individual |
| Full Name | JESSICA MORENO |
| Practice Address |
615 Bultman Dr Sumter SC 29150-2514 |
| Mailing Address |
3755 Rucker Dr Timmonsville SC 29161-9224 |
| Practice Telephone | 8033056194 |
| Practice Fax Number | 8033056197 |
| Mailing Telephone | 8434721218 |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 37860 | SC | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SC PHARMACIST LICENSE | 37860 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205435856 | Jessica Moreno | Specialist/Technologist | 3718 Duck Creek Dr, Garland, TX 75043-2962 | 2020-10-23 |
| 1932722782 | Jessica Anne Moreno | Registered Nurse | 24385 Wilderness Oak Apt 7302, San Antonio, TX 78258-7761 | 2020-05-27 |
| 1528524436 | Jessica Simone Moreno | Physical Therapist | 2840 Commercial Center Blvd Ste 103, Katy, TX 77494-6412 | 2019-02-15 |
| 1902388374 | Jessica Moreno | Licensed Vocational Nurse | 1401 Indian Creek Dr, Brownwood, TX 76801 | 2018-09-03 |
| 1306358759 | Jessica Nicole Moreno | Speech-Language Pathologist | 1309 Crestview Rd, Sterling, IL 61081-4315 | 2017-10-25 |
| 1598206088 | Jessica Moreno | Registered Nurse | 182 South Street Apt 8e, New York, NY 10038 | 2017-03-16 |
| 1528674082 | Jessica Moreno | Registered Nurse | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2020-09-21 |
| 1942841150 | Jessica Moreno | Technician | 5576 W Rochelle Ave, Las Vegas, NV 89103-3410 | 2019-09-30 |
| 1063066181 | Jessica Moreno | Behavior Technician | 17595 Almahurst St, City of Industry, CA 91748-1779 | 2019-07-26 |
| 1558828913 | Jessica Shanell Moreno | Behavioral Analyst | 865 Marina Bay Pkwy Ste 37, Richmond, CA 94804-6426 | 2019-02-21 |
| Street Address |
615 BULTMAN DR |
| City | SUMTER |
| State | SC |
| Zip Code | 29150-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730558024 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 615 Bultman Dr, Sumter, SC 29150-2514 | 2015-09-17 |
| 1942827068 | Leah Marie Carlisle | Pharmacist | 615 Bultman Dr, Sumter, SC 29150-2514 | 2020-07-06 |
| 1548825946 | Lauren Nicole Adamski | Pharmacist | 615 Bultman Dr, Sumter, SC 29150-2514 | 2019-05-01 |
| 1346725751 | Kara Wuenscher | Pharmacist | 615 Bultman Dr, Sumter, SC 29150-2514 | 2018-10-02 |
| 1326534389 | Christine Oliver Brogdon | Pharmacist | 615 Bultman Dr, Sumter, SC 29150-2514 | 2018-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| Find all providers in zip 29150 | ||||
| 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 |
|---|---|---|---|---|
| 1427569987 | Nicole Elizabeth Kennedy | Pharmacist | 343 Pinewood Rd, Sumter, SC 29150-5442 | 2017-10-23 |
| 1427409473 | Margaret Prince | Pharmacist | 556 Pittman Dr, Sumter, SC 29154-9467 | 2016-06-30 |
| 1477911147 | Ruth Strong Cummings | Pharmacist | 630 Saint Augustine Dr, Sumter, SC 29150-6020 | 2016-02-09 |
| 1710237243 | Braudy Emerson Byrd IIi | Pharmacist | 41 E. Calhoun St, Sumter, SC 29150 | 2012-09-12 |
| 1619235520 | Deja Vonelle Johnson | Pharmacist | 515 E Emerald Lake Dr, Sumter, SC 29153-7427 | 2012-04-27 |
| 1437421930 | Douglas Peters | Pharmacist | 1143 Broad St, Sumter, SC 29150-1971 | 2012-01-31 |
| 1598036147 | Dena Cribb Fender | Pharmacist | 2055 Wedgefield Rd, Sumter, SC 29154-4654 | 2012-01-12 |
| 1023398369 | Tiffany Dawn Howell | Pharmacist | 375 Pinewood Road, Sumter, SC 29150 | 2011-08-18 |
| 1518255132 | Joseph Edward Mcleod | Pharmacist | 225 N Washington St, Sumter, SC 29150-4204 | 2011-07-17 |
| 1376850735 | Ashley Nicole Swindler | Pharmacist | 375 Pinewood Rd, Sumter, SC 29150-5442 | 2010-09-08 |
| Find all providers in SUMTER | ||||
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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.