JEROME PRUSACK (NPI# 1225577463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225577463 |
| Entity Type | Individual |
| Full Name | JEROME PRUSACK |
| Practice Address |
6591 State Route 29 Springville PA 18844-7608 |
| Practice Telephone | 5707377004 |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RP000136L | PA | Pharmacy Service Providers |
| Street Address |
6591 STATE ROUTE 29 |
| City | SPRINGVILLE |
| State | PA |
| Zip Code | 18844-7608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447389721 | Elk Lake School District | Local Education Agency (LEA) | 2380 Elk Lake School Rd, Springville, PA 18844 | 2007-03-05 |
| 1437709581 | Rachel Brianne Pompey | Speech-Language Pathologist | 297 Hunter Rd Apt 4, Springville, PA 18844-7405 | 2019-09-19 |
| 1073025383 | Timothy Allen Jayne | Specialist/Technologist | 2380 Elk Lake School Rd, Springville, PA 18844-7710 | 2017-10-26 |
| 1306392105 | B-k Health Center, Inc | Clinic/Center | 2380 Elk Lake School Rd, Springville, PA 18844-7710 | 2016-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477447 | Skyler Claraence Farmer | Behavior Technician | 645 Swenson Ave Apt 6, Springville, UT 84663-2563 | 2020-11-06 |
| 1801493382 | Maxwell Marshall Mount | Social Worker | 249 Rodeo Dr, Springville, UT 84663-9472 | 2020-10-07 |
| 1841804226 | Nanilia Lara | Massage Therapist | 643 Swenson Ave Apt 2, Springville, UT 84663-2562 | 2020-09-03 |
| 1225642002 | Norma Juarez | Social Worker | 801 W 425 N, Springville, UT 84663-5077 | 2020-08-31 |
| 1437761814 | Chris Goodman | Specialist/Technologist | 1371 S 625 E, Springville, UT 84663-2602 | 2020-08-18 |
| 1518584655 | Maite Antola | Student in an Organized Health Care Education/Training Program | 434 E 400 S, Springville, UT 84663-2006 | 2020-07-05 |
| 1255956363 | Marylauren Agee | Dietitian, Registered | 120 Workman Dr, Springville, TN 38256-4345 | 2020-06-15 |
| 1407476583 | Morgan Lee Jones | Student in an Organized Health Care Education/Training Program | 1790 Copper Spring Rd, Springville, TN 38256-5435 | 2020-04-20 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1720614282 | Cynthia Ellen Rich | Peer Specialist | 98 Maple Ave, Springville, NY 14141-1508 | 2020-03-17 |
| Find all providers in SPRINGVILLE | ||||
| 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 |
|---|---|---|---|---|
| 1508394578 | Kathryn Clairena Stanton | Pharmacist | 160 Springville Station Blvd, Springville, AL 35146 | 2017-06-02 |
| 1699140061 | Darryl Ivanson | Pharmacist | 407 Foxridge Dr, Springville, IN 47462-5024 | 2015-12-10 |
| 1801200324 | Nathan Christian | Pharmacist | 1117 W 400 S, Springville, UT 84663-3061 | 2014-06-12 |
| 1124341128 | Susan K Bancroft | Pharmacist | 316 S.cascade Dr., Springville, NY 14141 | 2010-03-04 |
| 1538340278 | Darren W Love | Pharmacist | 184 So Cascade Dr, Springville, NY 14141 | 2007-11-23 |
| 1295915494 | Stephan D Seybolt | Pharmacist | 184 S Cascade Dr, Springville, NY 14141-9275 | 2007-11-06 |
| 1720689532 | Anna Stewart | Pharmacist | 660 S 1750 W, Springville, UT 84663-3071 | 2020-11-06 |
| 1134720485 | Rebecca Youngberg | Pharmacist | 660 S 1750 W, Springville, UT 84663-3071 | 2020-11-03 |
| 1700487360 | Daniel Clark | Pharmacist | 660 S 1750 W, Springville, UT 84663-3071 | 2020-11-02 |
| 1871106765 | Brandon Nielsen | Pharmacist | 420 S Main St, Springville, UT 84663-2251 | 2020-08-28 |
| Find all providers in SPRINGVILLE | ||||
| City | SPRINGVILLE |
| Zip Code | 18844 |
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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.