PERI STARK (NPI# 1528347150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528347150 |
| Entity Type | Individual |
| Full Name | PERI STARK |
| Practice Address |
62 Washington Street Ext Fair Haven VT 05743-4402 |
| Mailing Address |
65 Homestead Rd Saratoga Springs NY 12866-5806 |
| Practice Telephone | 8022653760 |
| Enumeration Date | 2011-08-13 |
| Last Update Date | 2011-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0330078234 | VT | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IMMUNIZING PHARMACIST | 202-0014 | 01 |
| Street Address |
62 WASHINGTON STREET EXT |
| City | FAIR HAVEN |
| State | VT |
| Zip Code | 05743-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700055738 | Dru Ann Pollinger | Veterinarian | 799 Rte 22a North, Fair Haven Animal Hospital, Fair Haven, VT 05743 | 2008-02-25 |
| 1720261787 | Nathan Fiske | Pharmacist | 62 Washington Street, Fair Haven, VT 05743 | 2007-12-13 |
| 1265645097 | The Owen House Ltd | Custodial Care Facility | 3 Union St, Fair Haven, VT 05743-1028 | 2007-05-08 |
| 1215934583 | Ryan P Mahar | Physical Therapist | 28 4th St, Fair Haven, VT 05743-1053 | 2005-07-01 |
| 1790162212 | Donna P Johnson Physical Therapy PC | Physical Therapist | 28 4th St, Fair Haven, VT 05743-1053 | 2015-05-05 |
| 1730466756 | Emily J Macura | Physical Therapist | 28 4th St, Fair Haven, VT 05743-1053 | 2011-11-04 |
| 1316945777 | Donna Plante | Physical Therapist | 28 4th St, Fair Haven, VT 05743-1053 | 2005-07-11 |
| 1255338539 | Donna P Johnson Physical Therapy PC | Physical Therapist | 28 4th St, Fair Haven, VT 05743-1053 | 2005-07-01 |
| 1154432540 | Jack Hamilton | Dentist | 129b N Main St, Fair Haven, VT 05743-1132 | 2006-08-31 |
| 1174814156 | H & K Dental Services,plc | Clinic/Center | 129b N Main St, Fair Haven, VT 05743-1132 | 2011-04-26 |
| Find all providers in zip 05743 | ||||
| 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 |
|---|---|---|---|---|
| 1720261787 | Nathan Fiske | Pharmacist | 62 Washington Street, Fair Haven, VT 05743 | 2007-12-13 |
| 1104437813 | Mallory Anne Ketcham | Pharmacist | 621 Route 22a N, Fair Haven, VT 05743-9239 | 2020-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427475 | Steven A Hollister | Pharmacist | 935 Shelburne Rd, South Burlington, VT 05403-6991 | 2020-11-04 |
| 1376143503 | Stacy Lynn Bilodeau | Pharmacist | 90 Shopping Plaza Rd, Rutland, VT 05701-5200 | 2020-10-27 |
| 1063029452 | Christina Barr | Pharmacist | 298 Partridge Rd, Barre, VT 05641-8913 | 2020-09-29 |
| 1689281495 | Adrian L Heal | Pharmacist | 114 Old Stage Rd, Putney, VT 05346-8609 | 2020-09-25 |
| 1174130157 | Justin Michael Boufford | Pharmacist | 218 Lower Mountian View Dr., Colchester, VT 05446 | 2020-09-24 |
| 1215498910 | Donald J Maloy | Pharmacist | 927 Frisbie Hill Rd, Castleton, VT 05735-9784 | 2019-03-26 |
| 1710457353 | Amber L Carrasquillo | Pharmacist | 438 Railroad St Apt 301, Saint Johnsbury, VT 05819 | 2018-11-27 |
| 1780153999 | Dustin Lea | Pharmacist | 792 College Pkwy Ste 103, Colchester, VT 05446-3052 | 2018-11-16 |
| 1366910689 | Keri Lecompte | Pharmacist | 379 Breezy Hill Acres, North Ferrisburgh, VT 05473-9608 | 2018-11-05 |
| 1326526062 | Bryan Elliot Petrow | Pharmacist | 823 Ferry Rd, Charlotte, VT 05445-9092 | 2018-08-03 |
| Find all providers with the same taxonomy | ||||
| City | FAIR HAVEN |
| Zip Code | 05743 |
Please comment or provide details below to improve the information on PERI STARK.
| 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.