JACOB TIMOTHY VANVLECK (NPI# 1669589933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669589933 |
| Entity Type | Individual |
| Full Name | JACOB TIMOTHY VANVLECK |
| Credential | PHARMD |
| Practice Address |
427 N 12th Street Plummer ID 83851-0388 |
| Mailing Address |
Po Box 388 427 N 12th Street Plummer ID 83851-0388 |
| Practice Telephone | 2086851931 |
| Practice Fax Number | 2086855511 |
| Mailing Telephone | 2086851931 |
| Mailing Fax Number | 2086855511 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2019-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | P6000 | ID | Pharmacy Service Providers |
| Street Address |
427 N 12TH STREET |
| City | PLUMMER |
| State | ID |
| Zip Code | 83851-0388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013447671 | Joshua Michael Severns | Counselor | 427 N 12th Street, Plummer, ID 83851 | 2017-06-15 |
| 1902248040 | Anthony Lee Peterson | Pharmacist | 427 N 12th Street, Plummer, ID 83851 | 2013-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326575325 | Terrin Loe | Dental Hygienist | 358-786 Long Road, Plummer, ID 83851 | 2017-05-22 |
| 1639542830 | Selene Bonnell-hall | Physical Therapy Assistant | 1100 A Street, Plummer, ID 83851 | 2015-11-10 |
| 1609245059 | Caley Jordan | Pharmacist | 427 N 12 St, Plummer, ID 83851 | 2015-09-16 |
| 1861741282 | Plummer Gateway Fire Protection | Ambulance | 609 Poleyard Rd, Plummer, ID 83851 | 2012-08-30 |
| 1497040349 | Jason Ford Chapman | General Practice | 427 N. 12th St., Plummer, ID 83851 | 2011-06-17 |
| 1861797060 | Tiffany Marie Korrer | Physical Therapy Assistant | 1100 A. Street, Plummer, ID 83851 | 2011-01-19 |
| 1710290234 | Brian Meyer | Optometrist | 427 Nth 12th St, Plummer, ID 83851 | 2010-07-26 |
| 1386884369 | James Smith | Clinical Medical Laboratory | 1115 E. St, Plummer, ID 83851 | 2009-03-03 |
| 1134378169 | Robert Samuel Davis | Physician Assistant | 427 N 12th St., Plummer, ID 83851 | 2008-09-15 |
| 1013192210 | Nikole J Mills | Nurse Practitioner | 427 N. 12th Street, Plummer, ID 83851 | 2008-01-07 |
| Find all providers in zip 83851 | ||||
| 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 |
|---|---|---|---|---|
| 1609245059 | Caley Jordan | Pharmacist | 427 N 12 St, Plummer, ID 83851 | 2015-09-16 |
| 1710499504 | Sara Holland | Pharmacist | 427 12th St, Plummer, ID 83851-4000 | 2017-11-02 |
| 1902248040 | Anthony Lee Peterson | Pharmacist | 427 N 12th Street, Plummer, ID 83851 | 2013-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950750 | Jill Willett | Pharmacist | 5453 Us Hwy 2, Priest River, ID 83856 | 2020-10-19 |
| 1568078046 | Peter Chad Adamovich | Pharmacist | 3553 Summit Dr, Pocatello, ID 83201-8011 | 2020-09-19 |
| 1932713765 | Richard Lee Wilgus | Pharmacist | 131 W Cameron Ave, Kellogg, ID 83837-2359 | 2020-08-31 |
| 1194335406 | Elizabeth Halcro | Pharmacist | 5453 Hwy 2, Priest River, ID 83856-8385 | 2020-08-03 |
| 1740890094 | Emilie Heun | Pharmacist | 10700 W Ustick Rd, Boise, ID 83713-5103 | 2020-08-02 |
| 1881212371 | Ngan T Nguyen | Pharmacist | 161 E. Prairie Shopping Center, Hayden, ID 83835 | 2020-07-10 |
| 1467071811 | Cassidy Paige Howarth | Pharmacist | 5861 Victor Meadows Dr, Victor, ID 83455-5482 | 2020-04-15 |
| 1477186542 | Mark David Johnston | Pharmacist | 1683 E Myrtle Beach Ct, Eagle, ID 83616-5366 | 2020-02-18 |
| 1386282572 | Renee L Patton | Pharmacist | 520 S Eagle Rd Ste 2108, Meridian, ID 83642-6363 | 2019-12-18 |
| 1437795259 | Paul Charles Villaret | Pharmacist | 1855 N Groveland Pl, Eagle, ID 83616-4275 | 2019-11-27 |
| Find all providers with the same taxonomy | ||||
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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.