MR. VINCENT D MOORE (NPI# 1295894145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295894145 |
| Entity Type | Individual |
| Full Name | MR. VINCENT D MOORE |
| Credential | R.PH. |
| Practice Address |
321 Jefferson St N Wadena MN 56482-1372 |
| Mailing Address |
181 Parkview Ave Wadena MN 56482-2407 |
| Practice Telephone | 2186314050 |
| Practice Fax Number | 2186312726 |
| Mailing Telephone | 2186314050 |
| Mailing Fax Number | 2186312726 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 110091-2 | MN | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | STATE PHARMACY LICENSE | 110091-2 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568655710 | Vincent A Moore Sr. | Counselor | 230 Ashmun St, Box 4, New Haven, CT 06511-3549 | 2007-08-21 |
| 1083654628 | Vincent Joseph Moore | Obstetrics & Gynecology | 2251 N Shore Dr, Rhinelander, WI 54501-8360 | 2006-06-08 |
| 1487612784 | Vincent Paul Moore | Preventive Medicine | 1600 Sw Archer Rd, Gainesville, FL 32610-5001 | 2006-05-03 |
| Street Address |
321 JEFFERSON ST N |
| City | WADENA |
| State | MN |
| Zip Code | 56482-1372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770594558 | Schwartzwald Drug Inc. | Pharmacy | 321 Jefferson St N, Wadena, MN 56482-1372 | 2006-08-10 |
| 1437644275 | Elizabeth Williamschen | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2018-06-25 |
| 1861934093 | Megan Miller | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2016-11-04 |
| 1508218538 | Kassandra Grimes | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2016-07-01 |
| 1417329582 | Kammy Larson | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2015-10-28 |
| 1992189096 | Molly Slaby | Pharmacist | 321 Jefferson St N, C/o Thrifty White Pharmacy, Wadena, MN 56482-1372 | 2015-07-17 |
| 1528467867 | Zachary Buchner | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2014-08-21 |
| 1740629823 | Nicole Rae Barnett | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2013-06-21 |
| 1902245210 | Jason Michael Pexsa | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2013-06-19 |
| 1457652497 | Thrifty Drug Stores Inc | Pharmacy | 321 Jefferson St N, Wadena, MN 56482-1372 | 2010-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033633904 | Hadc Wadena, LLC | Assisted Living Facility | 110 Hemlock Ave. Nw, Wadena, MN 56482 | 2017-08-01 |
| 1457665986 | Jill M Wilkens | Physician Assistant | 4 Deerwood Ave, Wadena, MN 56482 | 2010-07-26 |
| 1053525931 | Gerald Henry Gammell | Psychiatry & Neurology | 240 Shady Lane Drive, Wadena, MN 56482 | 2007-05-09 |
| 1336286228 | Wayne Calvin Howard | Dentist | 122 Sw Colfax, Wadena, MN 56482 | 2007-01-31 |
| 1699839399 | Peter W Finke | Physical Therapist | 311jefferson St. North, Tri County Hosptial, Wadena, MN 56482 | 2006-12-20 |
| 1902874480 | Corey H Tabbert | Optometrist | 222 Se First Street, Wadena, MN 56482 | 2006-03-09 |
| 1447333547 | Woodland Dental Inc | Dentist | 206 1st St Se, Wadena, MN 56482 | 2006-10-23 |
| 1306948245 | Wendy Amanda Gravelle | Nurse Anesthetist, Certified Registered | 415 Jefferson St North, Wadena, MN 56482 | 2006-09-01 |
| 1255312013 | Alfredmy G Chessor | General Practice | 4 Deerwood Ave Nw, Wadena, MN 56482 | 2005-11-09 |
| 1902961048 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 100 Juniper Ave, Wadena, MN 56482-1041 | 2006-12-27 |
| Find all providers in zip 56482 | ||||
| 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 |
|---|---|---|---|---|
| 1346612025 | Michelle Lynn Hinojos | Pharmacist | 14320 190th St, Wadena, MN 56482-4054 | 2015-10-21 |
| 1770573529 | Michael Frank Mertens | Pharmacist | 204 Jefferson St N, Wadena, MN 56482-1371 | 2005-10-24 |
| 1609474436 | Danelle Mary Vandermay | Pharmacist | 100 Juniper Ave, Wadena, MN 56482-1041 | 2020-10-14 |
| 1376141242 | Betsy Jo Lewis | Pharmacist | 100 Juniper Ave, Wadena, MN 56482-1041 | 2020-10-13 |
| 1437644275 | Elizabeth Williamschen | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2018-06-25 |
| 1861934093 | Megan Miller | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2016-11-04 |
| 1508218538 | Kassandra Grimes | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2016-07-01 |
| 1417329582 | Kammy Larson | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2015-10-28 |
| 1992189096 | Molly Slaby | Pharmacist | 321 Jefferson St N, C/o Thrifty White Pharmacy, Wadena, MN 56482-1372 | 2015-07-17 |
| 1528467867 | Zachary Buchner | Pharmacist | 321 Jefferson St N, Wadena, MN 56482-1372 | 2014-08-21 |
| Find all providers in WADENA | ||||
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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.