AMY JO GOODLICK (NPI# 1528669025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528669025 |
| Entity Type | Individual |
| Full Name | AMY JO GOODLICK |
| Credential | RPH |
| Practice Address |
1530 Walmart Dr Lebanon OH 45036-7342 |
| Practice Telephone | 5139326210 |
| Practice Fax Number | 5139326431 |
| Mailing Telephone | 5139326210 |
| Mailing Fax Number | 5139326431 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 26019622A | IN | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 03323961 | OH | Pharmacy Service Providers |
| Street Address |
1530 WALMART DR |
| City | LEBANON |
| State | OH |
| Zip Code | 45036-7342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538186713 | Wal-mart Stores East Lp | Pharmacy | 1530 Walmart Dr, Lebanon, OH 45036-7342 | 2006-07-16 |
| 1902407075 | David Orth | Pharmacist | 1530 Walmart Dr, Lebanon, OH 45036-7342 | 2020-11-05 |
| 1922609403 | Logan Blakeley | Pharmacist | 1530 Walmart Dr, Lebanon, OH 45036-7342 | 2020-11-03 |
| 1073747036 | Theffron and Associates LLC | Optometrist | 1530 Walmart Dr, Lebanon, OH 45036-7342 | 2009-05-06 |
| 1952414641 | Tracy Schmitt | Optometrist | 1530 Walmart Dr, Lebanon, OH 45036-7342 | 2006-08-16 |
| 1346250305 | Wal-mart Stores East, Lp | Technician/Technologist | 1530 Walmart Dr, Lebanon, OH 45036-7342 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205479458 | Natasha Denney Arentz | Nurse Practitioner | 5787 Oh-63, Lebanon, OH 45036 | 2019-10-21 |
| 1265086573 | Eric Stone | Counselor | 5234 Oh-63, Lebanon, OH 45036 | 2019-07-25 |
| 1548730401 | Crystal Prater | Counselor | 5234 W Sr 63, Lebanon, OH 45036 | 2018-12-04 |
| 1922574284 | Ellen L Fink | Counselor | 5234 Sr 63, Lebanon, OH 45036 | 2018-10-15 |
| 1255832275 | Primary Care Partners of Ohio | Family Medicine | 726 E Main St Ste F205, Lebanon, OH 45036 | 2018-02-25 |
| 1548769599 | Chelsea R Perkins | Case Manager/Care Coordinator | 975 Kingsview Drive Bldg B, Lebanon, OH 45036 | 2018-02-06 |
| 1184133829 | Mary Bennett | Speech-Language Pathologist | 6760 Oh St Rt. 34, Lynchburg, OH 45036 | 2017-09-26 |
| 1699292912 | Robert Earl Offutt | Counselor | 5234 State Rt.63, Lebanon, OH 45036 | 2017-08-28 |
| 1407381528 | Kari Bump | Counselor | 320 E Silver St, Lebanon, OH 45036 | 2017-04-26 |
| 1154780435 | Ohio Department of Rehabilitation and Correction | Public Health or Welfare | State Route 63, Lebanon, OH 45036 | 2016-02-16 |
| Find all providers in zip 45036 | ||||
| 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 |
|---|---|---|---|---|
| 1114541174 | Nextdoor Drug | Pharmacist | 932 W Main St, Lebanon, VA 24266 | 2020-06-04 |
| 1265063507 | Melyssia Marzerka | Pharmacist | 85 Mechanic St Ste C3-3, Lebanon, NH 03766-1537 | 2020-01-27 |
| 1831745439 | Amanda B Elkins | Pharmacist | 75 Oak Lawn Cir, Lebanon, VA 24266-6600 | 2019-08-11 |
| 1033560156 | Dianne L Gianakos | Pharmacist | 16 Chrystal Dr, Lebanon, NJ 08833-3245 | 2016-06-30 |
| 1083064836 | Charles Roberts II | Pharmacist | 597 Donald C. Moore Drive, Lebanon, VA 24266 | 2016-06-13 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1386014124 | Ashley Sanders | Pharmacist | 101 Woodland Dr, Lebanon, VA 24266-5366 | 2015-10-06 |
| 1962879676 | April Ballentine | Pharmacist | 19 North Mechanic St, Lebanon, OH 45036 | 2015-08-28 |
| 1982088985 | Troy Alan Miller | Pharmacist | 12 Centerra Pkwy Ste 10, Lebanon, NH 03766-1411 | 2015-07-20 |
| 1457782237 | Sandra Empey | Pharmacist | 363 Philadelphia Rd, Lebanon, TN 37087-8108 | 2013-12-04 |
| Find all providers in LEBANON | ||||
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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.