MRS. ANNIE CLARA WIDEMOND (NPI# 1447347992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447347992 |
| Entity Type | Individual |
| Full Name | MRS. ANNIE CLARA WIDEMOND |
| Credential | C.PH.T. |
| Practice Address |
1436 State Road 121 South Macclenny FL 32063 |
| Mailing Address |
507 Grissholm St P. O. Box 1192 Macclenny FL 32063-2613 |
| Practice Telephone | 9042595868 |
| Practice Fax Number | 9042595275 |
| Mailing Telephone | 9042596785 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 2901-0104-0756-9 | FL | Pharmacy Service Providers |
| Street Address |
1436 STATE ROAD 121 SOUTH |
| City | MACCLENNY |
| State | FL |
| Zip Code | 32063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467682997 | Alaina Daniele Waddell | Pharmacy Technician | 1436 State Road 121 South, Macclenny, FL 32063-5565 | 2009-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164976 | Justin Gary Dugger | Pharmacist | 9218 Sr-228 E, Macclenny, FL 32063 | 2020-11-03 |
| 1285175091 | Katie Rourke | Massage Therapist | 6068 -1 Larimer Rd, Macclenny, FL 32063 | 2017-03-13 |
| 1174734073 | Jane Ellen Echterling | Psychologist | Northeast Florida State Hospital, 7487 S. State Road 121, Macclenny, FL 32063 | 2007-05-24 |
| 1992879886 | Baker County Schools | Local Education Agency (LEA) | 290 Jonathan St E, Macclenny, FL 32063 | 2006-11-20 |
| 1306918271 | Baker County School Board | Local Education Agency (LEA) | 290 Jonathan Street East, Macclenny, FL 32063 | 2006-11-15 |
| 1780760967 | Patricia Ann Sova | Pharmacist | 1436 Sw 6th St, Winn Dixie #0144, Macclenny, FL 32063 | 2006-10-31 |
| 1003900713 | Luna S. Iskander | Psychiatry & Neurology | 7487 South State Road 121, Macclenny, FL 32063 | 2006-10-03 |
| 1558456103 | Cam Hoang | Family Medicine | 7487 South State Road 171, Macclenny, FL 32063 | 2006-10-03 |
| 1245323492 | Raynors Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 698 F W Macclenny Ave, Ste F, Macclenny, FL 32063 | 2006-10-02 |
| 1700977451 | Kimberly Diane Padgett | Pharmacist | 1436 State Rd 121 & I-10, Macclenny, FL 32063 | 2006-09-27 |
| Find all providers in zip 32063 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154422145 | Heidi Joan Vassallo | Pharmacy Technician | 1436 S 6th St, Macclenny, FL 32063-4623 | 2006-09-25 |
| 1467682997 | Alaina Daniele Waddell | Pharmacy Technician | 1436 State Road 121 South, Macclenny, FL 32063-5565 | 2009-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820234 | Roderick John Yulo Palma | Pharmacy Technician | 10538 Sw 16th St, Pembroke Pines, FL 33025-4784 | 2020-10-28 |
| 1700408374 | Andre Spencer | Pharmacy Technician | 5400 Nw 175th St, Miami Gardens, FL 33055-3541 | 2020-05-17 |
| 1295356509 | Kahkashan Fatimah | Pharmacy Technician | 8801 Hunters Lake Dr Apt 223, Tampa, FL 33647-2850 | 2020-04-28 |
| 1649803057 | Jenisse Quintela Lozano | Pharmacy Technician | 2108 W 53rd St, Hialeah, FL 33016-2031 | 2020-02-14 |
| 1528604717 | Bianca Apollon | Pharmacy Technician | 517 Okaloosa St Unit 1, Tallahassee, FL 32310-5424 | 2019-11-21 |
| 1033750971 | Arielle Lakeita Bryant | Pharmacy Technician | 11048 N Campus Blvd, Jacksonville, FL 32218-6416 | 2019-10-02 |
| 1821639931 | Jeviel Latrish Davis | Pharmacy Technician | 1127 Caliente Dr, Jacksonville, FL 32211-8855 | 2019-10-01 |
| 1750922654 | Jowana T'pring Preston-gray | Pharmacy Technician | 8711 Newton Rd Apt 249, Jacksonville, FL 32216-7514 | 2019-10-01 |
| 1487205654 | Tiera Chisolm | Pharmacy Technician | 1704 Mary Beth Dr, Middleburg, FL 32068-7833 | 2019-09-27 |
| 1306492434 | Ashlynn Da Silva | Pharmacy Technician | 2 N Us Highway 17 92, Debary, FL 32713-2506 | 2019-08-14 |
| Find all providers with the same taxonomy | ||||
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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.