ADDISON PHAN (NPI# 1396111407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396111407 |
| Entity Type | Individual |
| Full Name | ADDISON PHAN |
| Credential | PHARM.D. |
| Practice Address |
2433 25th Ave Gulfport MS 39501-4525 |
| Mailing Address |
10122 Fournier Ave Diberville MS 39540-5458 |
| Practice Telephone | 2285636886 |
| Mailing Telephone | 2283834698 |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2015-08-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | E-13961 | MS | Pharmacy Service Providers |
| Street Address |
2433 25TH AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-4525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457744856 | Lesley Eura Spencer | Pharmacist | 2433 25th Ave, Gulfport, MS 39501-4525 | 2015-03-09 |
| 1922556430 | Laura A Tran | Pharmacist | 2433 25th Ave, Gulfport, MS 39501-4525 | 2016-09-13 |
| 1467838771 | Amanda Skal | Pharmacist | 2433 25th Ave, Gulfport, MS 39501 | 2015-08-10 |
| 1417340811 | Meghan Maynard | Pharmacist | 2433 25th Ave, Gulfport, MS 39501-4525 | 2015-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| 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 |
|---|---|---|---|---|
| 1225637424 | Milagros H. Walker | Pharmacist | 2119 Lindhridge Dr, Gulfport, MS 39507-3765 | 2020-10-20 |
| 1508373259 | Raikeisha Harper | Pharmacist | 1520 Broad Ave Ste 300, Gulfport, MS 39501-3601 | 2018-01-03 |
| 1457744856 | Lesley Eura Spencer | Pharmacist | 2433 25th Ave, Gulfport, MS 39501-4525 | 2015-03-09 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1205272184 | Racheal Latoya Jones | Pharmacist | 505 Lipscomb Ct, Gulfport, MS 39507-2868 | 2013-05-17 |
| 1033409404 | Carl Vonbodungen | Pharmacist | 11179 Highway 49, Gulfport, MS 39503 | 2011-04-19 |
| 1124327044 | Lakeisha J Jackson-patton | Pharmacist | 11279 Highway 49, Gulfport, MS 39503-3396 | 2011-03-17 |
| 1023323235 | Steven James Juraszek | Pharmacist | 2 Pass Rd, Gulfport, MS 39507-3201 | 2010-08-11 |
| 1336326636 | Janelle E Joe | Pharmacist | 11312 Highway 49, Gulfport, MS 39503-3086 | 2008-01-29 |
| Find all providers in GULFPORT | ||||
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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.