SAMUEL RANDOLPH BALLENGEE (NPI# 1508985599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508985599 |
| Entity Type | Individual |
| Full Name | SAMUEL RANDOLPH BALLENGEE |
| Credential | PHARMD |
| Practice Address |
54 W 2nd Ave Williamson WV 25661-3506 |
| Mailing Address |
Po Box 538 Williamson WV 25661-0538 |
| Practice Telephone | 3044750080 |
| Practice Fax Number | 3044750080 |
| Mailing Telephone | 3044750080 |
| Mailing Fax Number | 3044750080 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RP0006318 | WV | Pharmacy Service Providers |
| Street Address |
54 W 2ND AVE |
| City | WILLIAMSON |
| State | WV |
| Zip Code | 25661-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710332135 | Jcl Management and Consulting LLC | Pharmacy | 54 W 2nd Ave, Williamson, WV 25661-3506 | 2016-05-04 |
| 1619330529 | Joseph Lee | Pharmacist | 54 W 2nd Ave, Williamson, WV 25661-3506 | 2016-03-30 |
| 1336339704 | Tug Valley Pharmacy LLC | Pharmacy | 54 W 2nd Ave, Williamson, WV 25661-3506 | 2007-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315715 | Leah Danielle Davis | Technician | Rr 1 200b, Left Fork Marrowbone, Williamson, WV 25661 | 2020-10-30 |
| 1487253209 | Rosalene Diamond | Technician | 398 Davis Branch Road, Wiilliamson, WV 25661 | 2020-10-22 |
| 1295332021 | Mary Ann Hickman | Technician | 144 Lincoln Street, Williamson, WV 25661 | 2020-10-05 |
| 1194322917 | Randy Lee Davis | Technician | 511 Dickerson Street Apt. #7, Williamson, WV 25661 | 2020-10-05 |
| 1679188320 | Deborah Ann Smith | Technician | 25 Ben Street, Williamson, WV 25661 | 2020-09-10 |
| 1356956262 | Jessica Ann Payne | Technician | 1203 Buffalo Creek Road, Lot#1, Williamson, WV 25661 | 2020-09-09 |
| 1154934396 | Jahala Kay Kozee | Technician | 164 Us Rt. 52, Williamson, WV 25661 | 2020-08-27 |
| 1952914186 | Ruth Elaine Kirk | Technician | 45 Wincole Lane, Williamson, WV 25661 | 2020-08-27 |
| 1831702208 | Mary Elizabeth Gilman | Technician | 436 State Route 65, Williamson, WV 25661 | 2020-08-26 |
| 1437760253 | Dianna Lynn Brown | Technician | 21 Old Field Branch Road, Williamson, WV 25661 | 2020-08-14 |
| Find all providers in zip 25661 | ||||
| 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 |
|---|---|---|---|---|
| 1619491776 | Breanne Peterson | Pharmacist | 4061 State Route 104, Williamson, NY 14589-9554 | 2017-07-31 |
| 1295917623 | John Lauren Somerville | Pharmacist | 4061 Route 104, Rite Aid # 10856, Williamson, NY 14589-9554 | 2007-11-27 |
| 1992882146 | Hurley Drug Inc | Pharmacist | Corner of 3rd Ave and Logan St, Williamson, WV 25661 | 2006-11-01 |
| 1780168633 | Charles Baisden | Pharmacist | 859 Alderson St, Williamson, WV 25661-3215 | 2018-09-17 |
| 1417430182 | Hershel Baker Jr. | Pharmacist | 48 1/2 W. 2nd Ave, Williamson, WV 25661 | 2018-09-10 |
| 1619330529 | Joseph Lee | Pharmacist | 54 W 2nd Ave, Williamson, WV 25661-3506 | 2016-03-30 |
| 1528439239 | Perry Joseph Ayoob | Pharmacist | 859 Alderson St, Williamson, WV 25661-3215 | 2015-10-08 |
| 1134535784 | Rebecca Ashley Mcpherson | Pharmacist | 859 Alderson St, Williamson, WV 25661-3215 | 2014-07-03 |
| 1770999542 | Larry David Simpkins | Pharmacist | 859 Alderson St, Williamson, WV 25661-3215 | 2014-07-01 |
| 1093060568 | Larry Jack New Jr. | Pharmacist | 210 Logan St, Williamson, WV 25661-3608 | 2012-07-19 |
| Find all providers in WILLIAMSON | ||||
| City | WILLIAMSON |
| Zip Code | 25661 |
Please comment or provide details below to improve the information on SAMUEL RANDOLPH BALLENGEE.
| 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.