TIMOTHY DANIEL PETERSEN (NPI# 1609158369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609158369 |
| Entity Type | Individual |
| Full Name | TIMOTHY DANIEL PETERSEN |
| Credential | R.PH. |
| Practice Address |
2045 S I 75 Business Loop Grayling MI 49738-2039 |
| Practice Telephone | 9893440374 |
| Practice Fax Number | 9893440968 |
| Mailing Telephone | 9893440374 |
| Mailing Fax Number | 9893440968 |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2011-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302029407 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891853453 | Timothy Dee Petersen | Chiropractor | 2351 Sunset Blvd, Ste 120, Rocklin, CA 95765 | 2006-12-05 |
| 1295737898 | Timothy J Petersen | Psychologist | 1 Bowdoin Sq, 7th Floor, Office 744, Boston, MA 02114-2927 | 2005-08-12 |
| 1275030892 | Timothy Lou Petersen | Registered Nurse | 1836 South Ave, La Crosse, WI 54601-5429 | 2018-04-10 |
| 1639468887 | Timothy C Petersen | Internal Medicine | 100 Constitution Dr, Ste 217, Va Beach, VA 23462-6799 | 2011-03-28 |
| 1104070119 | Timothy Allen Petersen | Psychologist | 16055 Ventura Blvd, Suite 920, Encino, CA 91436-2601 | 2008-11-05 |
| Street Address |
2045 S I 75 BUSINESS LOOP |
| City | GRAYLING |
| State | MI |
| Zip Code | 49738-2039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871536300 | Russell E Mancewicz | Pharmacist | 2045 S I 75 Business Loop, Grayling, MI 49738-2039 | 2006-06-13 |
| 1467733485 | Jeffrey B Emmons | Pharmacist | 2045 S I 75 Business Loop, Grayling, MI 49738-2039 | 2011-09-03 |
| 1720248859 | Walgreen Co | Pharmacy | 2045 S I 75 Business Loop, Grayling, MI 49738-2039 | 2008-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699275750 | Munson Healthcare Grayling | Psychologist | 1200 W North Down River Rd., Suite C, Grayling, MI 49738 | 2018-02-15 |
| 1922543073 | Autumn Book | Assistant Behavior Analyst | 6720 Tomahawk Trl, Grayling, MI 49738 | 2016-12-28 |
| 1942756796 | Kaitlyn A Smith | Pharmacist | 2425 S. Grayling Ave., Grayling, MI 49738 | 2016-08-31 |
| 1629484290 | Northern Michigan Endocrine Pllc | Clinic/Center | 1200 West North Down River Rd, Suite B, Grayling, MI 49738 | 2014-07-03 |
| 1033533427 | Krista Mohr | Nurse Anesthetist, Certified Registered | 1100 East Michigan Ave, Mercy Hospital- Grayling, Grayling, MI 49738 | 2014-02-06 |
| 1295034296 | Tomlin Capps Rosi | Surgery | 1250 E. Michigan Ave, Suite D, Grayling, MI 49738 | 2011-03-17 |
| 1265754667 | Pamela Birtcher Fisher | Counselor | 204 Meadows Drive, Grayling, MI 49738 | 2010-02-26 |
| 1942478797 | Marilyn L Rosi | Nurse Practitioner | 1010 W. North Down River Road, Grayling, MI 49738 | 2008-02-14 |
| 1558557454 | Jeffrey K Chaulk Md PC | Optometrist | 1200 N Down River Rd, Grayling, MI 49738 | 2007-09-25 |
| 1528288784 | G.r.a.c.e. Center | Counselor | 6459 West M-72, Grayling, MI 49738 | 2007-04-27 |
| Find all providers in zip 49738 | ||||
| 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 |
|---|---|---|---|---|
| 1285148239 | Peggy Curriston | Pharmacist | 708 Ogemaw St, Grayling, MI 49738-1420 | 2017-11-29 |
| 1942756796 | Kaitlyn A Smith | Pharmacist | 2425 S. Grayling Ave., Grayling, MI 49738 | 2016-08-31 |
| 1053554758 | Kelli Gail Gillispie | Pharmacist | 312 S James St, Grayling, MI 49738-1818 | 2009-04-09 |
| 1871536300 | Russell E Mancewicz | Pharmacist | 2045 S I 75 Business Loop, Grayling, MI 49738-2039 | 2006-06-13 |
| 1871547919 | Grayling Pharmacy Inc | Pharmacist | 208 E Michigan Ave, Grayling, MI 49738 | 2006-05-22 |
| 1003352923 | Marco Mares-saihua | Pharmacist | 312 S James St, Grayling, MI 49738-1818 | 2017-01-17 |
| 1407207780 | Travis Alger | Pharmacist | 312 S James St, Grayling, MI 49738-1818 | 2016-06-28 |
| 1861862492 | Eric Prosen Schacht | Pharmacist | 312 S James St, Grayling, MI 49738-1818 | 2015-09-25 |
| 1750780607 | Rite Aid Pharmacy | Pharmacist | 312 S James St, Grayling, MI 49738-1818 | 2014-08-16 |
| 1861805558 | Jude Busong Fonguh | Pharmacist | 312 S James St, Grayling, MI 49738-1818 | 2014-06-10 |
| Find all providers in GRAYLING | ||||
Please comment or provide details below to improve the information on TIMOTHY DANIEL PETERSEN.
| 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.