DR. MANDY FAITH ANTKIEWICZ (NPI# 1699043406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699043406 |
| Entity Type | Individual |
| Full Name | DR. MANDY FAITH ANTKIEWICZ |
| Credential | PHARMD |
| Practice Address |
3500 Central Ave Lake Station IN 46405-2271 |
| Practice Telephone | 2199637355 |
| Practice Fax Number | 2199631562 |
| Mailing Telephone | 2199637355 |
| Mailing Fax Number | 2199631562 |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26021689A | IN | Pharmacy Service Providers |
| Street Address |
3500 CENTRAL AVE |
| City | LAKE STATION |
| State | IN |
| Zip Code | 46405-2271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366053357 | Jennifer Niemeyer | Pharmacist | 3500 Central Ave, Lake Station, IN 46405-2271 | 2020-08-12 |
| 1689083198 | Dante Ramon Golston | Pharmacist | 3500 Central Ave, Lake Station, IN 46405-2271 | 2014-08-08 |
| 1568731859 | Angela Esther Balfanz | Pharmacist | 3500 Central Ave, Lake Station, IN 46405-2271 | 2011-12-15 |
| 1518972652 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3500 Central Ave, Lake Station, IN 46405-2271 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245507748 | Melissa Goldsberry | Pharmacist | 9500 Central Avenue, Lake Station, IN 46405 | 2011-11-28 |
| 1518085992 | Nikki A Wargo Dds | Dentist | 2370 E 37th Ave, Lake Station, IN 46405 | 2007-03-26 |
| 1336214493 | Civil City of Lake Station Ind | Ambulance | 1876 Fairview Ave, Lake Station, IN 46405 | 2006-11-22 |
| 1720511785 | Patience Tieri | Nurse Practitioner | 2490 Central Ave, Lake Station, IN 46405 | 2017-04-06 |
| 1982041893 | Nanette Lindesmith | Nurse Practitioner | 3304 Parkside Ave, Lake Station, IN 46405 | 2013-05-31 |
| 1639249212 | Maria Rosario Badar | Internal Medicine | 3820 Central Ave, Lake Station, IN 46405 | 2006-11-09 |
| 1972895647 | Northshore Health Centers, Inc. | Family Medicine | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2011-05-12 |
| 1215289186 | Kari Payton | Specialist/Technologist | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2012-10-02 |
| 1972637171 | Southlake Tricity Rba | Custodial Care Facility | 2075 Ripley St, Lake Station, IN 46405-1161 | 2007-03-16 |
| 1699043190 | Jennifer Marie Legg | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2011-12-12 |
| Find all providers in zip 46405 | ||||
| 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 |
|---|---|---|---|---|
| 1245507748 | Melissa Goldsberry | Pharmacist | 9500 Central Avenue, Lake Station, IN 46405 | 2011-11-28 |
| 1366053357 | Jennifer Niemeyer | Pharmacist | 3500 Central Ave, Lake Station, IN 46405-2271 | 2020-08-12 |
| 1689083198 | Dante Ramon Golston | Pharmacist | 3500 Central Ave, Lake Station, IN 46405-2271 | 2014-08-08 |
| 1568731859 | Angela Esther Balfanz | Pharmacist | 3500 Central Ave, Lake Station, IN 46405-2271 | 2011-12-15 |
| 1366670663 | Amy Janette Maxberry | Pharmacist | 2490 Central Ave, Lake Station, IN 46405-2122 | 2009-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710728 | Joel Burke Hood | Pharmacist | 5034 E Timberwood Dr, Newburgh, IN 47630-3018 | 2020-11-08 |
| 1346841582 | Autumn Brooke Trifone | Pharmacist | 1795 In 163, Clinton, IN 47842 | 2020-11-04 |
| 1043811326 | Brunhilda K Waingeh | Pharmacist | 4008 Decker Ct, Sellersburg, IN 47172-9258 | 2020-11-04 |
| 1659972834 | Crenda Bottorff | Pharmacist | 1835 East Us 231 South, Crawfordsville, IN 47935 | 2020-11-04 |
| 1114528585 | Shannon Allcron | Pharmacist | 6770 E. Virginia St., Evansville, IN 47715 | 2020-11-03 |
| 1558962860 | Andrea Abbett | Pharmacist | 333 Boyd Blvd Laporte, In 46350, 211 S 75 E, Valparaiso, IN 46383 | 2020-11-03 |
| 1588265052 | Sarah Corder | Pharmacist | 2633 W 450 N, La Porte, IN 46350-7507 | 2020-11-02 |
| 1447851928 | Alicia Helene Wojciechowski | Pharmacist | 5829 N New Jersey St, Indianapolis, IN 46220-2534 | 2020-11-02 |
| 1871194472 | Megan Mccullough | Pharmacist | 10617 East Washington Street, Pharmacy At Walmart, Indianapolis, IN 46222 | 2020-11-02 |
| 1013518646 | Philip Anthony Card | Pharmacist | 823 W State Highway 46 Ste 1p1, Spencer, IN 47460-6748 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
| City | LAKE STATION |
| Zip Code | 46405 |
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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.