MS. CHANTHEARA LONG


Address: 1 Va Ctr, Augusta, ME 04330-6719
Phone: 2076238411

MS. CHANTHEARA LONG (NPI# 1619499910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619499910
Entity Type Individual
Full Name MS. CHANTHEARA LONG
Credential PHARMD
Practice Address 1 Va Ctr
Augusta
ME 04330-6719
Mailing Address 2 Choate Ln Apt 205
Hallowell
ME 04347-1735
Practice Telephone 2076238411
Enumeration Date 2017-07-09
Last Update Date 2017-07-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1835P0018X Pharmacist
Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PH236555 MA Pharmacy Service Providers

Office Location

Street Address 1 VA CTR
City AUGUSTA
State ME
Zip Code 04330-6719

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437135704 Nancy Louise Johnson Counselor 1 Va Ctr, Building 206, Augusta, ME 04330-6719 2005-12-19
1730789710 Monica Rachel Lee Pharmacist 1 Va Ctr, Augusta, ME 04330-6795 2020-10-28
1336746841 Danae E. Stuart Nurse Practitioner 1 Va Ctr, Augusta, ME 04330-6795 2020-10-07
1699380774 Erica Wolfe Pharmacist 1 Va Ctr, Augusta, ME 04330-6795 2020-09-15
1790303436 Danny Sarkis Student in an Organized Health Care Education/Training Program 1 Va Ctr, Augusta, ME 04330-6795 2020-07-09
1518585256 Elizabeth Sullivan Student in an Organized Health Care Education/Training Program 1 Va Ctr, Augusta, ME 04330-6795 2020-07-09
1710504907 Katie S Eastman Pharmacist 1 Va Ctr, Augusta, ME 04330-6795 2020-07-03
1548885429 Rebecca Labonte Dietitian, Registered 1 Va Ctr, Augusta, ME 04330-6795 2020-06-16
1942824362 Whitney C Sargent Pharmacist 1 Va Ctr, Augusta, ME 04330-6795 2020-06-01
1336785708 Matthew Douglas Campbell Physician Assistant 1 Va Ctr, Augusta, ME 04330-6719 2019-11-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770181877 Renewal Family Center, LLC Community/Behavioral Health 10 Learners Drive, Augusta, ME 04330 2020-10-12
1134748759 Chelsea Simone Koch Registered Nurse 1 Va Center, Department of Veterans Affairs, Augusta, ME 04330 2020-04-14
1790238442 Nicole Lacrosse Behavioral Analyst 53 Hayden Rd, Augusta, ME 04330 2016-07-29
1093176844 Richard J. Larrabee Counselor 312 Townhouse Road, Chelsea, ME 04330 2016-03-08
1376910984 Sarah C. A. Tatlock Social Worker 41 Anthony Ave, Augusta, ME 04330 2015-08-31
1457728180 Va Maine Health General Acute Care Hospital 1 Va Center 05, Va Maine Healthcare System-togus, Augusta, ME 04330 2015-08-28
1043696842 Megan Arsenault Pharmacist 403 Water Street, Augusta, ME 04330 2015-08-04
1205219987 Trevor Holbert Audiologist 1 Va Center - Togus Va Medical Center, Audiology 126a, Augusta, ME 04330 2015-06-30
1659787836 Hannah M. Pullen Occupational Therapy Assistant 12 Shuman Ave Ste 16, Augusta, ME 04330 2014-07-08
1831469899 Tanya Bernadette Quarterman Specialist 153 Hospital St Ste 13, Augusta, ME 04330 2012-01-09
Find all providers in zip 04330

Taxonomy Information

Taxonomy Code 1835P0018X
Grouping Pharmacy Service Providers
Classification Pharmacist
Specialization Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316276033 Susan Christine Fagan Pharmacist Hm 1220 1120 15th Street, University of Georgia College of Pharmacy, Augusta, GA 30912 2009-12-08
1609491281 Melinda Kezer Drylie Pharmacist 1 Freedom Way, Augusta, GA 30904-6258 2020-06-10
1669009619 Dalton Nuse Pharmacist 1510 Ohio St, Augusta, KS 67010-2189 2020-03-26
1740787472 Katherine Donnan Pharmacist 1 Freedom Way, Augusta, GA 30904-6258 2018-04-09
1396244034 Reid Wallace Griffin Pharmacist 1537 Walton Way, Augusta, GA 30904-3764 2018-02-08
1457726663 Sudharsan Periyasamy Thandavan Pharmacist 2744 Washington Rd, Augusta, GA 30909-2218 2015-12-14
1902274921 Anishka Walker Pharmacist 950 15th St, Charlie Norwood Vamc - Pharmacy Department, Augusta, GA 30901-2608 2015-09-08
1073992020 Kathleen Cleary Pharmacist 1 Va Ctr, Augusta, ME 04330-6719 2015-05-22
1477946531 Amber Ladak Pharmacist 1120 15th St, Augusta, GA 30912-0004 2015-03-13
1699165548 Tim Robinson Pharmacist 1120 15th St, Bi-2101, Augusta, GA 30912-0004 2015-01-30
Find all providers in AUGUSTA

Competitor

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City AUGUSTA
Zip Code 04330

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Dataset Information

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.

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