DR. JARED DEROSSI (NPI# 1598210445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598210445 |
| Entity Type | Individual |
| Full Name | DR. JARED DEROSSI |
| Credential | PHARMD |
| Practice Address |
117a Village Rd Ne Leland NC 28451-7413 |
| Practice Telephone | (910) 371-6363 |
| Mailing Telephone | (910) 371-6363 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 26482 | NC | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | I062106-1 | NY | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 464 Main St, Port Jefferson, NY 117772814 | 6314732498 | 6314738865 |
| Street Address |
117A VILLAGE RD NE |
| City | LELAND |
| State | NC |
| Zip Code | 28451-7413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679881783 | Sean Patrick Gray | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2010-09-23 |
| 1346857455 | Shatima Parish | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2020-09-23 |
| 1356974844 | Nicholas Vachon | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2020-02-13 |
| 1740561513 | Michelle Duncan Caison | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2011-09-07 |
| 1275814592 | Andrew J Doherty IIi | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2011-08-31 |
| 1427336833 | Kenneth Earl Kasten | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2011-08-02 |
| 1376821264 | Jaimenee Patel | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2011-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811427156 | Town of Leland | Ambulance | 1004 Village Rd, Leland, NC 28451 | 2017-06-19 |
| 1205389517 | Total Renal Care of North Carolina LLC | Clinic/Center | 1220 Magnolia Village Way, Leland, NC 28451 | 2016-08-03 |
| 1043696800 | William Sanders Sr. | Respite Care | 3043 Ramble Dr, Leland, NC 28451 | 2015-08-04 |
| 1457730707 | Devinn L Geeson | Dentist | 1215 Westgate Drive, Suite 180, Leland, NC 28451 | 2015-05-20 |
| 1740611706 | Mark C. Austin Omfs, Pllc | Oral & Maxillofacial Surgery | 2001 South Baxter Drive, Leland, NC 28451 | 2013-12-02 |
| 1750711123 | Donna Rose Hodnicki | Nurse Practitioner | 1132 East Cutler Crossing, Leland, NC 28451 | 2013-11-20 |
| 1992137996 | Abbey Jones Mcclanahan | Physical Therapist | 1003 Olde Waterford Way # B, Leland, NC 28451 | 2013-08-01 |
| 1306010780 | Walter B. Futch, Jr. Dds Pa | Dentist | 1006 Northgate Drive, Leland, NC 28451 | 2008-04-17 |
| 1639357429 | Sbh- Wilmington, LLC | Psychiatric Hospital | 2050 Mercantile Drive, Leland, NC 28451 | 2008-02-05 |
| 1396930137 | F.a.c. Group Homes, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 9485 Huckabee Ct, Leland, NC 28451 | 2007-09-13 |
| Find all providers in zip 28451 | ||||
| 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 |
|---|---|---|---|---|
| 1205207727 | Jocelyn Anne Ott | Pharmacist | 1222 Maple Tree Dr, 301, Leland, NC 28451-9170 | 2015-10-09 |
| 1679881783 | Sean Patrick Gray | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2010-09-23 |
| 1346857455 | Shatima Parish | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2020-09-23 |
| 1871107441 | Jalpa R Pandya | Pharmacist | 1112 New Pointe Blvd, Leland, NC 28451-4115 | 2020-09-01 |
| 1952914160 | Melanie Loughner | Pharmacist | 1112 New Pointe Blvd, Leland, NC 28451-4115 | 2020-08-26 |
| 1356974844 | Nicholas Vachon | Pharmacist | 117a Village Rd Ne, Leland, NC 28451-7413 | 2020-02-13 |
| 1326694555 | Nicolas Haines | Pharmacist | 1019 Grandiflora Dr, Leland, NC 28451-7453 | 2019-08-13 |
| 1568908549 | Meredith Erin Hall | Pharmacist | 1112 New Pointe Blvd, Leland, NC 28451-4115 | 2017-01-13 |
| 1942755939 | Katlyn Dorazio | Pharmacist | 1019 Grandiflora Dr, Leland, NC 28451-7453 | 2016-08-18 |
| 1487021044 | Madison Hoover | Pharmacist | 2021 Olde Regent Way, Leland, NC 28451-4192 | 2015-08-28 |
| Find all providers in LELAND | ||||
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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.