MR. THOMAS EDWARD SULLIVAN (NPI# 1215064050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215064050 |
| Entity Type | Individual |
| Full Name | MR. THOMAS EDWARD SULLIVAN |
| Credential | R.PH. |
| Practice Address |
1010 S. Ponce Deleon Blvd Winn-dixie Pharmacy St Augustine FL 32084 |
| Mailing Address |
1563 Barrington Cir St Augustine FL 32092-3619 |
| Practice Telephone | 9048252181 |
| Practice Fax Number | 9048293643 |
| Mailing Telephone | 9049401680 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | MA 15211 | MA | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | NC 8523 | NC | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | PS25069 | FL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203386 | Thomas Carson Bruyer Sullivan | Physical Therapist | Bst Granite Falls, 345 10th Avenue, Granite Falls, MN 56241 | 2019-09-04 |
| 1992156426 | Thomas Patrick Sullivan | Counselor | 5 Prentiss Pl, Medfield, MA 02052-1652 | 2016-06-27 |
| 1437565488 | Thomas Barrett Sullivan | Orthopaedic Surgery | 1611 W Harrison St Ste 201, Chicago, IL 60612-4861 | 2014-07-09 |
| 1508104373 | Thomas Sullivan | Psychiatry & Neurology | 16321 Mack Ave, Detroit, MI 48224-2756 | 2013-01-29 |
| 1003033283 | Thomas Edward Sullivan | Dentist | 1200 High Ridge Parkway, Westchester, IL 60154 | 2007-04-19 |
| 1447391222 | Thomas Paul Sullivan | Counselor | 6 Cedarview Rd, Ipswich, MA 01938-1604 | 2007-02-12 |
| 1871630111 | Thomas E Sullivan | Internal Medicine | 6 Brackenbury Ln, Beverly, MA 01915-3822 | 2007-01-30 |
| 1548379233 | Thomas S Sullivan | Chiropractor | 481 Ferry St, Malden, MA 02148-7851 | 2006-08-29 |
| 1780691253 | Thomas Ryan Sullivan | Chiropractor | 7106 Pippin Rd, Cincinnati, OH 45239 | 2006-08-01 |
| 1295742419 | Thomas S Sullivan | Family Medicine | 12018 Sunrise Valley Dr, Suite 400, Reston, VA 20191-3432 | 2006-08-01 |
| Street Address |
1010 S. PONCE DELEON BLVD WINN-DIXIE PHARMACY |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347599 | Cody Martyn | Pharmacist | 955 Fl-16, St. Augustine, FL 32084 | 2020-08-18 |
| 1912562471 | Kjcares Suportive Living Services | Case Manager/Care Coordinator | 20 First Street, Apt 5, St. Augustine, FL 32084 | 2019-05-09 |
| 1558841684 | Kevin D Roberts | Psychologist | 20 First Street Apt 5, St. Augustine, FL 32084 | 2018-08-17 |
| 1568954576 | Gwendolyn Marie Spong | Nurse Practitioner | 2703 N Ponce De Leon Blvd., Minute Clinic #3591, Area 4, Region 46, St. Augustine, FL 32084 | 2018-06-05 |
| 1770940116 | Marian L. Turner-sharpton, Lcsw | Social Worker | 17 Pacific St., Suite 2 (growth Pointe), St. Augustine, FL 32084 | 2016-01-15 |
| 1710358932 | Florida Laboratory Analysis, LLC | Clinical Medical Laboratory | 1690 Us Highway 1 S Ste D, St Augustine, FL 32084 | 2015-10-14 |
| 1780064774 | J Mae Transportation | Non-emergency Medical Transport (VAN) | 28 N Whitney St Apt 404, St Augustine, FL 32084 | 2015-06-04 |
| 1497154520 | Suzanne Smith Weed | Nurse Practitioner | 32 Mulberry Street, Saint Augustine, FL 32084 | 2014-08-14 |
| 1447684469 | Rachel Moran | Counselor | 162 Oneida Street, St. Augustine, FL 32084 | 2013-08-27 |
| 1932545993 | Matrix Medical, LLC | Durable Medical Equipment & Medical Supplies | 56 S Dixie Hwy Ste 1, St Augustine, FL 32084 | 2013-05-17 |
| Find all providers in zip 32084 | ||||
| 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 |
|---|---|---|---|---|
| 1831580273 | Jeffery Dean Keith Jr. | Pharmacist | 200 Paseo Terraza Unit 205, St Augustine, FL 32095-8877 | 2015-02-06 |
| 1194141119 | Dino Ajloni | Pharmacist | 4405 Sartillo Rd, St Augustine, FL 32095-5240 | 2014-03-14 |
| 1295162782 | Vincent C Pfab | Pharmacist | 549 Fox Hollow Ln, St Augustine, FL 32086-5402 | 2013-09-30 |
| 1649604182 | Kenneth E Good | Pharmacist | 101 S Ponce De Leon Blvd, St Augustine, FL 32084-4213 | 2013-08-31 |
| 1477890275 | William Anderson II | Pharmacist | 69 Valencia St, St Augustine, FL 32084-3541 | 2013-01-14 |
| 1699012641 | Stephen Ross Mayhood Jr. | Pharmacist | 4255 Us 1 S Ste 1, St Augustine, FL 32086-7000 | 2013-01-10 |
| 1376888156 | Jeffrey Lynn Humerick | Pharmacist | 3305 Woodbury Ct, St Augustine, FL 32086-5088 | 2012-12-04 |
| 1619259694 | Dennis R Sibley II | Pharmacist | 2801 N Ponce Deleon Blvd, St Augustine, FL 32084 | 2011-09-15 |
| 1477886224 | Brian N Kurz | Pharmacist | 5440 State Road 16, St Augustine, FL 32092 | 2009-09-11 |
| 1619114360 | Swarna L Pachigalla | Pharmacist | 3905 A1a S, St Augustine, FL 32080-6933 | 2009-01-17 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32084 |
Please comment or provide details below to improve the information on MR. THOMAS EDWARD SULLIVAN.
| 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.