KENNETH WAGNER (NPI# 1588941462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588941462 |
| Entity Type | Individual |
| Full Name | KENNETH WAGNER |
| Practice Address |
27 East Ave Lewiston ME 04240-6645 |
| Mailing Address |
21 Pearl St Lewiston ME 04240-5645 |
| Practice Telephone | 2077846666 |
| Mailing Telephone | 2077843294 |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2011-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PR3110 | ME | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518286657 | Kenneth F Wagner | Internal Medicine | 206 Gulfview Dr, Islamorada, FL 33036-4113 | 2010-05-28 |
| 1700804309 | Kenneth W Wagner | Physician Assistant | 17115 Red Oak Dr, Suite 211, Houston, TX 77090-2641 | 2006-07-18 |
| Street Address |
27 EAST AVE |
| City | LEWISTON |
| State | ME |
| Zip Code | 04240-6645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073014015 | Nicholas Jalbert | Pharmacist | 27 East Ave, Lewiston, ME 04240-6645 | 2018-02-26 |
| 1760769731 | Robert Michael Collins | Pharmacist | 27 East Ave, Lewiston, ME 04240-6645 | 2011-11-04 |
| 1487600912 | Shaws Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 27 East Ave, Lewiston, ME 04240 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773882 | Hannah Page Guerrette | Speech-Language Pathologist | 2 Strawberry Ave, Lewiston, ME 04240 | 2020-09-03 |
| 1497392500 | Samuel C Larouche | Social Worker | 100 Campus Ave Stes A&b, Lewiston, ME 04240 | 2019-12-09 |
| 1972145019 | Pomarand Behavioral Services | Nurse Practitioner | 217 Main St., Suite 201, Lewiston, ME 04240 | 2019-10-10 |
| 1396248258 | William Bucklin | Counselor | 17 Main St Fl 2, Lewiston, ME 04240 | 2018-03-16 |
| 1548769524 | Kevin Ryan | Physician Assistant | 12 High Street Suite 102, Lewiston, ME 04240 | 2018-02-06 |
| 1033637673 | Wellness Center | Clinic/Center | 37 Park Street, Suite 305, Lewiston, ME 04240 | 2017-09-04 |
| 1710404561 | Colasante Chiropractic, LLC | Clinic/Center | 184 Webster Street, #100, Lewiston, ME 04240 | 2017-08-23 |
| 1609398544 | Lindsey Laforge | Occupational Therapist | 984 1/2 Sabattus Street, Lewiston, ME 04240 | 2017-07-12 |
| 1861922478 | Seth Toothaker | Counselor | 1190 Lisbon Street, Lewiston, ME 04240 | 2017-06-15 |
| 1861850828 | Black Bear Support Services, LLC | Community/Behavioral Health | 571 Sabattus Street, Suite 15, Lewiston, ME 04240 | 2016-02-05 |
| Find all providers in zip 04240 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205175924 | Sarah M Smith | Pharmacist | 15 Challenger Dr, Lewiston, ME 04240-1041 | 2013-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609109917 | Archie R. Jones | Pharmacist | 15 Shapleigh Rd, Kittery, ME 03904-1401 | 2009-09-18 |
| 1023241130 | Thomas Cremona | Pharmacist | 124 Turkey Lane Rd, Livermore, ME 04253-4204 | 2009-08-24 |
| 1699240242 | Nancie Mccard | Pharmacist | 15 Hospital Dr, York, ME 03909-1011 | 2018-10-10 |
| 1164904538 | Devin A Steuber | Pharmacist | 465 Main St, Westbrook, ME 04092-4328 | 2018-09-03 |
| 1083121560 | Nicholas James Sawicki | Pharmacist | 35 Park St, Milo, ME 04463-1152 | 2018-01-05 |
| 1457860595 | Tamica Ann Day | Pharmacist | 225 Madison Ave, Skowhegan, ME 04976-2054 | 2017-09-20 |
| 1700305273 | Harvard Samuel Bridges | Pharmacist | 75 Main St, Bucksport, ME 04416-4025 | 2017-09-15 |
| 1619499910 | Chantheara Long | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2017-07-09 |
| 1225491723 | Carrie Lee Leichtweis | Pharmacist | 489 State St, Bangor, ME 04401-6616 | 2016-04-01 |
| 1073992020 | Kathleen Cleary | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2015-05-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KENNETH WAGNER.
| 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.