KEESEVILLE PHARMACY INC (NPI# 1245318658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245318658 |
| Entity Type | Organization |
| Organization Name | KEESEVILLE PHARMACY INC |
| Other Organization Name | KEESEVILLE PHARMACY INC |
| Practice Address |
1730 Front St Keeseville NY 12944-3618 |
| Practice Telephone | 5188346090 |
| Practice Fax Number | 5188347021 |
| Mailing Telephone | 5188346090 |
| Mailing Fax Number | 5188347021 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-06-23 |
| Authorized Official Name | DANIEL BOSLEY (SUPV PHRM) |
| Authorized Official Telephone | 5188346090 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
017834 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00775571 | 05 | |
| PK | 2061794 | 01 |
| Other Name | Type Code |
|---|---|
| KEESEVILLE PHARMACY INC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932639937 | Keeseville Pharmacy Inc | Pharmacy | 1730 Front St, Keeseville, NY 12944-3618 | 2017-06-13 |
| Street Address |
1730 FRONT ST |
| City | KEESEVILLE |
| State | NY |
| Zip Code | 12944-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932639937 | Keeseville Pharmacy Inc | Pharmacy | 1730 Front St, Keeseville, NY 12944-3618 | 2017-06-13 |
| 1881759819 | Daniel Allan Bosley | Pharmacist | 1730 Front St, Keeseville, NY 12944-3618 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952841702 | Ellen Supinski | Specialist | 1701 Front Street, Keeseville, NY 12944 | 2017-02-27 |
| 1326385857 | Jessica Drinkwine | Specialist | 1850 Route 22, Keeseville, NY 12944 | 2013-01-03 |
| 1891160388 | Melody Hyatt | Early Intervention Provider Agency | 1717 Front Street, Keesville, NY 12944-0000 | 2015-12-09 |
| 1639605397 | Nancy Simington | Occupational Therapy Assistant | 46 School St Apt 1, Keeseville, NY 12944-1014 | 2017-05-02 |
| 1831423367 | Heidemarie Macdougal | Licensed Practical Nurse | 40 Cedar Ct, Keeseville, NY 12944-1100 | 2009-10-01 |
| 1891251641 | Paul Schmid | Taxi | 55 Cedar Ct, Keeseville, NY 12944-1134 | 2019-02-18 |
| 1366745556 | Maria Rheaume | Psychologist | 1 Mill St, Keeseville, NY 12944-1215 | 2010-12-10 |
| 1205230851 | Tara Parton | Licensed Practical Nurse | 85 Chesterfield St, Keeseville, NY 12944-1229 | 2014-10-10 |
| 1104139245 | Marshia Ellen Desorcie | Social Worker | 92 Clinton St, Keeseville, NY 12944-1261 | 2010-07-19 |
| 1770799298 | Judith Renee Feigenbaum | Genetic Counselor, MS | 61 River St, Keeseville, NY 12944-1276 | 2007-05-14 |
| Find all providers in zip 12944 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| Find all providers with the same taxonomy | ||||
| City | KEESEVILLE |
| Zip Code | 12944 |
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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.