TREVOR GORDON (NPI# 1780952150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780952150 |
| Entity Type | Individual |
| Full Name | TREVOR GORDON |
| Practice Address |
2014 S Broad St Philadelphia PA 19145-2305 |
| Practice Telephone | 2155513818 |
| Practice Fax Number | 2155513884 |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PHARMACIST | PA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PHARMACIST | RP044554L | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417276874 | Trevor Allan Gordon Jr. | Behavioral Analyst | 7901 Ne 10th St Ste C116, Midwest City, OK 73110-3653 | 2010-05-25 |
| 1154983088 | Trevor Smith Gordon | Case Manager/Care Coordinator | 344 E 100 S, Slc, UT 84111-1700 | 2019-07-01 |
| Street Address |
2014 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19145-2305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285901504 | Robert Jason Spencer | Pharmacist | 2014 S Broad St, Philadelphia, PA 19145-2305 | 2011-12-01 |
| 1871105403 | Kelley Johnson | Pharmacist | 2014 S Broad St, Philadelphia, PA 19145-2305 | 2020-08-17 |
| 1033637681 | Steven Chi Lam | Pharmacist | 2014 S Broad St, Philadelphia, PA 19145 | 2017-09-05 |
| 1013380328 | Meg Short | Pharmacist | 2014 S Broad St, Philadelphia, PA 19145-2305 | 2015-11-09 |
| 1477937357 | Annabel Ye Li | Pharmacist | 2014 S Broad St, Philadelphia, PA 19145-2305 | 2015-07-10 |
| 1184027054 | Jay Kim | Pharmacist | 2014 S Broad St, Philadelphia, PA 19145-2305 | 2014-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564350 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2300a Rear W Oregon Ave, Philadelphia, PA 19145 | 2020-10-05 |
| 1376069559 | Kyle James Hughes | Physical Therapist | 2192 W Oregon Ave Fl 3, Philadelphia, PA 19145 | 2017-08-18 |
| 1821519752 | John A Takacs Dmd | Clinic/Center | 1707w Passyunk Ave, Philadelphia, PA 19145 | 2017-06-30 |
| 1033573209 | Kenneth Donahue | Dentist | 1517 Packer Avenue, Philadelphia, PA 19145 | 2016-04-13 |
| 1437516895 | Kimberly Wyand | Physical Therapist | 2129 Oregon St, Philadelphia, PA 19145 | 2016-01-15 |
| 1760856538 | Liji Vipin | Nurse Practitioner | 1615 Oregon Ave, Philadelphia, PA 19145 | 2015-11-17 |
| 1528333846 | Gina Marie Doyle | Registered Nurse | 1930 S. Broad Street, Philadelphia, PA 19145 | 2012-03-20 |
| 1639446214 | Thao T Tran | Pharmacist | 2014-24 South Broad St, Philadelphia, PA 19145 | 2011-11-25 |
| 1649573171 | Phyllis Yang | Internal Medicine | 1700 S Broad St, Unit 201, Philadelphia, PA 19145 | 2010-12-05 |
| 1326364613 | South Philadelphia Open Mri, LLC | Clinic/Center | 1834 West Oregon Avenue, Philadelphia, PA 19145 | 2010-04-13 |
| Find all providers in zip 19145 | ||||
| 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 |
|---|---|---|---|---|
| 1063013704 | Truong Vu | Pharmacist | 1675 Christopher Columbus Blvd, Philadelphia, PA 19148-1402 | 2020-11-07 |
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1639797574 | Nikia Moody | Pharmacist | 3300 S Broad St, Philadelphia, PA 19145-5802 | 2020-07-07 |
| 1730706136 | William Galson | Pharmacist | 2732 E Venango St, Philadelphia, PA 19134-6121 | 2020-07-01 |
| 1801413489 | Kim-anh Tran | Pharmacist | 633 W Rittenhouse St Apt A204, Philadelphia, PA 19144-4327 | 2020-06-30 |
| 1376160374 | Amjad Azzawe | Pharmacist | 1335 Mount Vernon St, Philadelphia, PA 19123-3211 | 2020-06-25 |
| 1861017345 | Alice Hong Chandler | Pharmacist | 1405 S 10th St # At, Philadelphia, PA 19147-5608 | 2020-06-10 |
| 1710509518 | Nicholas Jospeh Carroll | Pharmacist | 21302 Delaire Landing Rd, Philadelphia, PA 19114-5205 | 2020-05-14 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1871129809 | Adina Klingman | Pharmacist | 5800 Woodland Ave, Philadelphia, PA 19143-5918 | 2020-03-21 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19145 |
Please comment or provide details below to improve the information on TREVOR GORDON.
| 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.