ATHENA PETERSON (NPI# 1194196170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194196170 |
| Entity Type | Individual |
| Full Name | ATHENA PETERSON |
| Practice Address |
474 Chamberlain Hwy Meriden CT 06451-1818 |
| Mailing Address |
49 Harrison Ln Bethlehem CT 06751-2102 |
| Practice Telephone | 2032171562 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0013072 | CT | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588916027 | Athena Peterson | Counselor | 13320 Ne 89th St, Redmond, WA 98052-1998 | 2012-10-08 |
| 1326266560 | Athena Peterson | Massage Therapist | 23100 Pacific Hwy S, Ste 201, Des Moines, WA 98198-7281 | 2007-04-23 |
| Street Address |
474 CHAMBERLAIN HWY |
| City | MERIDEN |
| State | CT |
| Zip Code | 06451-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528080124 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2006-07-24 |
| 1104295054 | Target | Pharmacy | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2015-09-22 |
| 1730457938 | Rebecca Vitale | Pharmacist | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2011-12-02 |
| 1659650497 | Adam Bruce Plumley | Pharmacy Technician | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2011-08-10 |
| 1881988152 | Maggie Jean Cross | Pharmacist | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2011-06-04 |
| 1407908981 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1235599333 | Mcm Dental, LLC | Dentist | 74 Main Street, Lakewood, CT 06451 | 2016-03-02 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
| Find all providers in zip 06451 | ||||
| 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 |
|---|---|---|---|---|
| 1306230453 | Daina Smith | Pharmacist | 8023 K4 Hwy, Meriden, KS 66512-9052 | 2015-03-26 |
| 1598166217 | Florence Alila-ciampolillo | Pharmacist | 245 E Woodland St, Apt 29, Meriden, CT 06451-2000 | 2014-09-12 |
| 1699111708 | Dong G Nguyen | Pharmacist | 7210 K4 Hwy Ste A, Meriden, KS 66512-9389 | 2013-05-15 |
| 1063033264 | Komal Patel | Pharmacist | 153 Broad St, Meriden, CT 06450-6550 | 2020-04-29 |
| 1780242008 | Shuai Wang | Pharmacist | 425 W Main St, Meriden, CT 06451-3816 | 2019-06-01 |
| 1700389996 | Diane Servedio | Pharmacist | 172 W Main St, Meriden, CT 06451-4104 | 2018-03-14 |
| 1871008813 | Tara Raymaakers | Pharmacist | 485 Broad St, Meriden, CT 06450-5801 | 2017-12-13 |
| 1710491634 | Nicole Marie Davoren | Pharmacist | 825 E Main St, Meriden, CT 06450-6064 | 2017-11-30 |
| 1952814535 | Brooke Sheridan | Pharmacist | 839 E Main St, Meriden, CT 06450-6006 | 2017-11-06 |
| 1346752532 | Maria Beaudoin | Pharmacist | 172 W Main St, Meriden, CT 06451-4104 | 2017-10-29 |
| Find all providers in MERIDEN | ||||
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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.