LARRY DEAN ANDERSON (NPI# 1780619106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780619106 |
| Entity Type | Individual |
| Full Name | LARRY DEAN ANDERSON |
| Credential | R.PH. |
| Practice Address |
1003 Willow Creek Rd Prescott AZ 86301-1641 |
| Mailing Address |
2114 N Eldred Rd Chino Valley AZ 86323-5212 |
| Practice Telephone | 9287715364 |
| Practice Fax Number | 9287715502 |
| Mailing Telephone | 9287715364 |
| Mailing Fax Number | 9287715502 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 8973 | AZ | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ PHARMACIST LICENSE | 8973 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336436799 | Larry James Anderson | Internal Medicine | 2076 Continental Dr Ne, Atlanta, GA 30345-3400 | 2011-07-06 |
| 1891090643 | Larry Anderson | Counselor | 3455 W Craig Rd, Unit C, North Las Vegas, NV 89032-5118 | 2011-01-25 |
| 1104150879 | Larry L Anderson | Counselor | 1418 Shafter Ave, Odessa, TX 79761-3131 | 2009-09-28 |
| 1124156880 | Larry Gene Anderson | Chiropractor | 7 Melgrove Ln, Ste 101, Hannibal, MO 63401-2275 | 2007-03-02 |
| 1356485924 | Larry L Anderson | Psychologist | 2124 Dupont Ave S Ste 202, Minneapolis, MN 55405-2700 | 2007-02-16 |
| 1699825190 | Larry Douglas Anderson | Dentist | 11736 Impressive View Drive, Deadwood, SD 57732-0154 | 2007-01-10 |
| 1326156530 | Larry Anderson | Massage Therapist | 20015 Highway 99, Ste A, Lynnwood, WA 98036 | 2006-08-28 |
| 1144267766 | Larry D Anderson Jr. | Internal Medicine | 2201 Inwood Rd, Dallas, TX 75235 | 2006-06-01 |
| 1790737401 | Larry G Anderson | Orthopaedic Surgery | 503 E Parker Rd, Morganton, NC 28655-5104 | 2006-05-17 |
| 1184802092 | Larry Anderson | Technician, Other | 500 Highway 51 S, Ripley, TN 38063-4583 | 2008-02-01 |
| Street Address |
1003 WILLOW CREEK RD |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528343 | Robert William Halterman | Family Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2005-06-15 |
| 1083211320 | Wendy E Nelson | Dietitian, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1668 | 2020-10-08 |
| 1750909008 | Shawn Jeffery Mitchell | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2020-07-13 |
| 1669019683 | Justin Earl Rogers | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-12-09 |
| 1477116911 | Anna Mattson | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-04-19 |
| 1790276608 | Phillip Allen Schafer | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301 | 2018-05-25 |
| 1144724618 | Richard Barclay Thompson | Respiratory Therapist, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2018-03-20 |
| 1245774397 | Stephen Green | Physician Assistant | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-12-08 |
| 1427500107 | Zachary Archer | Perfusionist | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-10-28 |
| 1952753675 | Candice Panton | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| 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 |
|---|---|---|---|---|
| 1760937759 | Courtney Edel | Pharmacist | 901 Willow Lake Rd, Prescott, AZ 86301-4617 | 2016-08-18 |
| 1215303862 | Sonja Dutch | Pharmacist | 1211 Squirrel Run, Prescott, AZ 86303-6444 | 2015-08-18 |
| 1104221423 | Jayson Robertson | Pharmacist | 1151 W Iron Springs Rd Ste D, Prescott, AZ 86305-1614 | 2014-10-29 |
| 1699174490 | Diane Rindone | Pharmacist | 1547 Marvin Gardens Ln, Prescott, AZ 86301-5530 | 2014-08-18 |
| 1548679988 | Lance Sandleben | Pharmacist | 222 Grace Ave, Prescott, AZ 86303-3439 | 2014-08-11 |
| 1336558683 | Emily Gunnerson | Pharmacist | 3050 E State Route 69, Prescott, AZ 86301-6743 | 2014-08-11 |
| 1184048381 | Nathan C Crow | Pharmacist | 3050 N Highway 69, Prescott, AZ 86301-9708 | 2014-02-07 |
| 1083054340 | Zachariah J Davis | Pharmacist | 1573 Sierry Peaks Dr Unit A, Prescott, AZ 86305-2153 | 2013-07-01 |
| 1275812786 | Allison Kreutzberg | Pharmacist | 178 E Sheldon, Prescott, AZ 86301 | 2011-08-15 |
| 1588965859 | Antonella Sola | Pharmacist | 518 Westwood Dr, Prescott, AZ 86303-3436 | 2010-11-03 |
| Find all providers in PRESCOTT | ||||
Please comment or provide details below to improve the information on LARRY DEAN ANDERSON.
| 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.