AMY LYNNE VAILLANCOURT (NPI# 1720504509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720504509 |
| Entity Type | Individual |
| Full Name | AMY LYNNE VAILLANCOURT |
| Credential | PHARMD. |
| Practice Address |
194 E Main St Fort Kent ME 04743-1428 |
| Mailing Address |
Po Box 221 Fort Kent ME 04743-0221 |
| Practice Telephone | 2078341690 |
| Practice Fax Number | 2078341691 |
| Mailing Telephone | 2074499060 |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2019-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PR46755 | ME | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | MAINE BOARD OF PHARMACY | PR46755 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 182 Market St Ste 2, Fort Kent, ME 047431514 | 2078342880 | 2078342882 |
| Street Address |
194 E MAIN ST |
| City | FORT KENT |
| State | ME |
| Zip Code | 04743-1428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467441774 | Alexandre Gennadievich Andrianov | Internal Medicine | 194 E Main St, Fort Kent, ME 04743-1428 | 2005-10-19 |
| 1366041113 | Jordan Albert | Pharmacist | 194 E Main St, Fort Kent, ME 04743-1428 | 2020-10-22 |
| 1093330441 | Stephanie Lynne Michaud | Nurse Practitioner | 194 E Main St, Fort Kent, ME 04743-1428 | 2020-06-11 |
| 1306485511 | Jodi Pearl Cote | Nurse Practitioner | 194 E Main St, Fort Kent, ME 04743-1428 | 2020-01-06 |
| 1003459231 | Alicia Lyn Soucy | Nurse Practitioner | 194 E Main St, Fort Kent, ME 04743-1428 | 2019-10-21 |
| 1558904771 | Crystal Lynn Hughes | Social Worker | 194 E Main St, Fort Kent, ME 04743-1428 | 2019-10-21 |
| 1851942429 | Northern Maine Medical Center | Pharmacy | 194 E Main St, Fort Kent, ME 04743-1428 | 2019-09-25 |
| 1316507437 | Andrna Erica Christopher | Nurse Practitioner | 194 E Main St, Fort Kent, ME 04743-1428 | 2019-06-20 |
| 1760946107 | Kelly Ann Lozier | Occupational Therapist | 194 E Main St, Fort Kent, ME 04743-1428 | 2019-01-30 |
| 1578027405 | Leslie-ann Labonte | Occupational Therapist | 194 E Main St, Fort Kent, ME 04743-1428 | 2019-01-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483874 | Megan K Pelletier | Pharmacist | Address: 182 Market St Suite 2, Fort Kent, ME 04743 | 2020-09-30 |
| 1629344171 | Sherry Marie Stedt | Massage Therapist | 590 Caribou Rd, Fort Kent, ME 04743 | 2012-03-29 |
| 1215140181 | School Administrative District 27 | Student in an Organized Health Care Education/Training Program | 84 Pleasant Street, Suite 1, Fort Kent, ME 04743 | 2007-05-08 |
| 1578785846 | M.s.a.d.#27 | Student in an Organized Health Care Education/Training Program | 108 Pleasant Street, Fort Kent, ME 04743 | 2007-05-03 |
| 1598880122 | Kristy Jo Nadeau | Social Worker | 210 Market St., Fort Kent, ME 04743 | 2007-03-20 |
| 1619066297 | Paul W Tisher | Psychiatry & Neurology | 104 East Main Street, Fort Kent, ME 04743 | 2006-10-12 |
| 1326150467 | Paul Huges Mcbreairty | Obstetrics & Gynecology | 468 St John Rd, Fort Kent, ME 04743 | 2006-08-31 |
| 1356459739 | Louis J Paradis Inc | Pharmacy | 62 West Main Street, Suite 101, Fort Kent, ME 04743 | 2006-08-27 |
| 1023024585 | Richard Raymond | Dentist | 139 Market Street, Suite 107, Fort Kent, ME 04743 | 2006-08-01 |
| 1003898677 | Lisa M. Eno | Nurse Practitioner | 197 East Main Street, Suite 101, Fort Kent, ME 04743 | 2005-11-18 |
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| 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 |
|---|---|---|---|---|
| 1609483874 | Megan K Pelletier | Pharmacist | Address: 182 Market St Suite 2, Fort Kent, ME 04743 | 2020-09-30 |
| 1417157363 | Hugh A Hartman Jr. | Pharmacist | 27 N Perley Brook Rd, Fort Kent, ME 04743-1925 | 2007-07-19 |
| 1366041113 | Jordan Albert | Pharmacist | 194 E Main St, Fort Kent, ME 04743-1428 | 2020-10-22 |
| 1992324974 | John Dennis Fitzgerald | Pharmacist | 182 Market St Ste 2, Fort Kent, ME 04743-1514 | 2020-04-10 |
| 1003164583 | Christie Skinner Freeman | Pharmacist | 84 E Main St, Fort Kent, ME 04743-1322 | 2012-08-15 |
| 1154621696 | Charles J Ouellette | Pharmacist | 182 Market St, Suite 2, Fort Kent, ME 04743-1514 | 2010-11-01 |
| 1114235397 | Janice Ann Collins | Pharmacist | 84 E Main St, Fort Kent, ME 04743-1322 | 2010-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295624 | Melissa Foss | Pharmacist | 797 Roosevelt Trl, Windham, ME 04062-5341 | 2020-11-06 |
| 1023619202 | Scott Thomas Castonguay | Pharmacist | 20 Sokokis Trl, Waterboro, ME 04087-3056 | 2020-11-04 |
| 1336709377 | Jordan Christine Anderson | Pharmacist | 183 Center St, Bangor, ME 04401-4839 | 2019-06-20 |
| 1669035804 | Vesna Kravljaca | Pharmacist | 1406 Congress St, Portland, ME 04102-2119 | 2019-04-14 |
| 1407327422 | Christopher Nordgren D'amico | Pharmacist | 93 Oak Grove Dr, Brewer, ME 04412-1200 | 2018-12-17 |
| 1831667278 | Anna Levesque | Pharmacist | 220 Us-1, Ste 1, Bucksport, ME 04416 | 2018-11-04 |
| 1164903639 | Peter Kombakis | Pharmacist | 137 Ray St, Portland, ME 04103-4320 | 2018-08-23 |
| 1124508338 | Brittany Noel Shofner | Pharmacist | 478 Us Route 1, Yarmouth, ME 04096-6735 | 2018-08-16 |
| 1336627785 | Tiffany M Bricker | Pharmacist | 165 Capitol St, Augusta, ME 04330-6232 | 2018-07-29 |
| 1861979825 | Sarah Stansauk | Pharmacist | 12 Marion Dr, Hampden, ME 04444-1726 | 2018-07-23 |
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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.