MR. JERRY STEWART STODDARD JR. (NPI# 1669721304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669721304 |
| Entity Type | Individual |
| Full Name | MR. JERRY STEWART STODDARD JR. |
| Credential | RPH |
| Practice Address |
224 East Butler Road Mauldin SC 29662 |
| Practice Telephone | 8642341282 |
| Mailing Telephone | 8642341282 |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | SC5414 | SC | Pharmacy Service Providers |
| Street Address |
224 EAST BUTLER ROAD |
| City | MAULDIN |
| State | SC |
| Zip Code | 29662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154862399 | Connie Painter | Behavior Technician | 103 Miller Rd, Mauldin, SC 29662 | 2017-03-20 |
| 1073061610 | Lisa Rist | Counselor | 400 South Main St Suite C, Mauldin, SC 29662 | 2016-09-12 |
| 1285181347 | Jennifer Wise | Specialist/Technologist | 310 Neely Ferry Road, Mauldin, SC 29662 | 2016-09-07 |
| 1467908236 | Maan Aziz Kerzzo | Pharmacist | 129 West Butler Road, Mauldin, SC 29662 | 2016-08-31 |
| 1083011357 | Southeast Transportation Services LLC | Non-emergency Medical Transport (VAN) | 411 N. Main St., Mauldin, SC 29662 | 2014-12-02 |
| 1174926471 | Holly Christine Waite | Chiropractor | 785 E Butler Rd, Ste D, Mauldin, SC 29662 | 2014-09-30 |
| 1194138701 | Vanessa Vance-logan | Case Manager/Care Coordinator | 400 West Butler Road; Suite B-1, Mauldin, SC 29662 | 2014-06-11 |
| 1265771984 | Connie Mae Lenagh | Nurse Practitioner | 924 E. Butler Rd, Mauldin, SC 29662 | 2013-02-01 |
| 1679823918 | Linda W Gerhart | Pharmacist | 224 East Butler Rd, Mauldin, SC 29662 | 2012-09-13 |
| 1114277894 | David Merz Banks | Pharmacist | 315 West Butler Rd, Mauldin, SC 29662 | 2012-09-11 |
| Find all providers in zip 29662 | ||||
| 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 |
|---|---|---|---|---|
| 1467908236 | Maan Aziz Kerzzo | Pharmacist | 129 West Butler Road, Mauldin, SC 29662 | 2016-08-31 |
| 1679823918 | Linda W Gerhart | Pharmacist | 224 East Butler Rd, Mauldin, SC 29662 | 2012-09-13 |
| 1669722120 | Judith Fofung | Pharmacist | 207 W Butler Rd, Mauldin, SC 29662-2536 | 2012-09-12 |
| 1114277894 | David Merz Banks | Pharmacist | 315 West Butler Rd, Mauldin, SC 29662 | 2012-09-11 |
| 1891044996 | Tucker W Poston | Pharmacist | 315 West Butler Road, Mauldin, SC 29662 | 2012-09-05 |
| 1427326040 | Jihyun Park | Pharmacist | 207 West Butler Rd, Mauldin, SC 29662 | 2011-12-09 |
| 1245559285 | Kelly Gainey Christopher | Pharmacist | 129 W Butler Rd, Mauldin, SC 29662-2534 | 2010-05-28 |
| 1639781537 | Kristin Marie Long | Pharmacist | 315 W Butler Rd, Mauldin, SC 29662-2531 | 2020-08-20 |
| 1952896300 | Hleb Fedarovich | Pharmacist | 104 W Butler Rd, Mauldin, SC 29662-2535 | 2018-06-28 |
| 1548714215 | Bao Tran | Pharmacist | 104 W Butler Rd, Mauldin, SC 29662-2535 | 2016-08-10 |
| Find all providers in MAULDIN | ||||
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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.