DR. MARK GUSTAFSON (NPI# 1346633492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346633492 |
| Entity Type | Individual |
| Full Name | DR. MARK GUSTAFSON |
| Credential | PHARM.D. |
| Practice Address |
494 Butternut Dr Holland MI 49424-1556 |
| Practice Telephone | 6167862235 |
| Mailing Telephone | 6167862235 |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302039944 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306919931 | Mark Charles Gustafson | Chiropractor | 3916 W 113th St, Bloomington, MN 55437-3503 | 2006-11-15 |
| 1114033214 | Mark Edward Gustafson | Dentist | 3431 Commerce Parkway, Suite A, Wooster, OH 44691 | 2006-08-22 |
| 1467439000 | Mark D. Gustafson | Family Medicine | 115 10th Ave Ne, Deer River, MN 56636-8795 | 2005-12-26 |
| 1851667000 | Mark Leroy Gustafson | Emergency Medicine | 3110 Maccorkle Ave Se, Charleston, WV 25304-1210 | 2012-03-31 |
| 1134108756 | Mark Gustafson | Obstetrics & Gynecology | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2006-01-12 |
| Street Address |
494 BUTTERNUT DR |
| City | HOLLAND |
| State | MI |
| Zip Code | 49424-1556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134136112 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 494 Butternut Dr, Holland, MI 49424-1556 | 2006-08-02 |
| 1932476942 | Robert Michael Kiviniemi | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2011-11-18 |
| 1295002483 | Jacob Tibbe | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2011-11-16 |
| 1144597386 | Nhuquynh Nguyen | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2011-11-16 |
| 1790060788 | Jeffrey Allen Nieboer | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2011-10-21 |
| 1780969014 | Annette Bringedahl | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2011-10-18 |
| 1396809042 | Gary Alan Schra | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290999 | Anderson Family and Cosmetic Dentistry | Dentist | 453 136th Ave., Holland, MI 49424 | 2018-10-08 |
| 1487139663 | Maria C. Hoekstra Dds, P.C. | Dentist | 1121 Ottawa Beach Road, Suite 100, Holland, MI 49424 | 2018-10-03 |
| 1871024000 | Derek Schaaf | Rehabilitation Practitioner | 13835 Foxtrail Dr., Holland, MI 49424 | 2017-03-21 |
| 1699227397 | Tabitha Margritz | Optometrist | 2279 N Park Drive #910, Holland, MI 49424 | 2016-10-28 |
| 1619373701 | Miller Chiropractic LLC | Chiropractor | 84 East Lakewood Boulevard, Holland, MI 49424 | 2014-11-17 |
| 1891107611 | Nathan B. Poel | Dentist | 1180 Ottawa Beach Rd, Suite E, Holland, MI 49424 | 2014-05-28 |
| 1477990802 | Jeanine Hamilton | Speech-Language Pathologist | 1576 Eb Creek Dr., Holland, MI 49424 | 2013-05-24 |
| 1194062638 | Stefan John Kuipers | Physician Assistant | 3100 Wellness Dr, Holland, MI 49424 | 2013-01-03 |
| 1902155690 | Benjamin Eovaldi | General Practice | 376 Mayfair St., Holland, MI 49424 | 2012-09-10 |
| 1295017929 | Employee Assistance Center Garden | Psychologist | 372 Garden, Holland, MI 49424 | 2011-09-20 |
| Find all providers in zip 49424 | ||||
| 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 |
|---|---|---|---|---|
| 1437775715 | Danijela Hart | Pharmacist | 425 N Division Ave, Holland, MI 49424-6467 | 2020-06-22 |
| 1518491489 | Sarah Jeanne Saigeon | Pharmacist | 1018 Abbey Ct, Apt 5, Holland, MI 49423-7400 | 2017-04-17 |
| 1881126373 | Derek Miller | Pharmacist | 132 Douglas Ave, Holland, MI 49424-6514 | 2017-04-03 |
| 1518368851 | Irene R Belder | Pharmacist | 12 Thoroughbred Dr, Holland, PA 18966-2570 | 2014-09-05 |
| 1275884710 | Joel Jeffrey Goodman | Pharmacist | 5 Larch Cir, Holland, PA 18966-2161 | 2012-09-24 |
| 1205186343 | Danielle Adler | Pharmacist | 44 Ponderosa Dr, Holland, PA 18966-2240 | 2012-09-17 |
| 1326325523 | Annie Varughese | Pharmacist | 139 Lark Dr, Holland, PA 18966 | 2011-11-16 |
| 1700162963 | Lynn Mae Nowak | Pharmacist | 4191 65th St, Holland, MI 49423-9733 | 2011-11-01 |
| 1649555335 | Melissa Sue Timmer | Pharmacist | 1496 Stillwater Dr, Holland, MI 49424-6173 | 2011-10-13 |
| 1174813828 | Lindsay M Vandonkelaar | Pharmacist | 973 Washington Ave, Holland, MI 49423-5228 | 2011-04-14 |
| Find all providers in HOLLAND | ||||
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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.