COLLEEN WISTER (NPI# 1912007436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912007436 |
| Entity Type | Individual |
| Full Name | COLLEEN WISTER |
| Practice Address |
2230 Cottman Ave Philadelphia PA 19149-1230 |
| Mailing Address |
500 S Broad St Philadelphia PA 19146-1613 |
| Practice Telephone | 2156850616 |
| Mailing Telephone | 2156856864 |
| Mailing Fax Number | 2157901651 |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | Pharmacy Service Providers |
| Street Address |
2230 COTTMAN AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19149-1230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194123034 | Anthony Boyce | Pharmacist | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2014-12-09 |
| 1891113585 | Daniel Chung | Family Medicine | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2014-03-31 |
| 1609163815 | Ravi Joseph Nagraj | Internal Medicine | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2011-07-08 |
| 1962794735 | Joan Rosen Bloch | Nurse Practitioner | 2230 Cottman Ave, First Floor, Philadelphia, PA 19149-1230 | 2011-05-11 |
| 1962738765 | Diane Zameska | Nurse Practitioner | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2009-10-29 |
| 1417170507 | Stanislava Kilimnik | Pharmacy Technician | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2007-04-10 |
| 1720115280 | Deepthi Reddy Foxhall | Family Medicine | 2230 Cottman Ave, Health Center # 10, Philadelphia, PA 19149-1230 | 2007-02-28 |
| 1932267374 | Rebecca S Conrad | Obstetrics & Gynecology | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2006-12-05 |
| 1033201215 | Donald Hannon | Pharmacist | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2006-09-28 |
| 1104925411 | Hae Sook Han | Pharmacist | 2230 Cottman Ave, Philadelphia, PA 19149-1230 | 2006-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508418948 | Double Care Inc | Clinic/Center | 2900-14 Cottman Ave, Philadelphia, PA 19149 | 2019-07-16 |
| 1710539457 | Xiao Rong Li | Adult Companion | 2900 - 14 Cottman Avenue, Philadelphia, PA 19149 | 2019-07-12 |
| 1154982775 | K Dental LLC | Clinic/Center | 6214 Bustleton Avenue, Philadelphia, PA 19149 | 2019-06-25 |
| 1851950430 | Halo Staffing Agency, LLC | Home Health | 6401 Akron St., Philadelphia, PA 19149 | 2019-06-07 |
| 1518450626 | Family First Home Healthcare LLC | In Home Supportive Care | 1405 Alcott St, Philadelphia, PA 19149 | 2018-06-13 |
| 1992106926 | Elena Semprevivo | Dentist | 2107 Cottman Avenue, Philadelphia, PA 19149 | 2014-09-09 |
| 1518366988 | Abundant Life Home Health Services | Home Health | 6632-46 Bustleton Ave, Philadelphia, PA 19149 | 2014-08-21 |
| 1598189771 | Citywide Community Counseling Services | Clinic/Center | 1346 Knorr St, Philadelphia, PA 19149 | 2014-02-10 |
| 1114341328 | Citywide Community Counseling Services | Clinic/Center | 5807 Bustleton Avenue, Philadelphia, PA 19149 | 2014-02-07 |
| 1790115509 | Norman Huynh | Physical Therapist | 6595 B East Roosevelt Boulevard, Philadelphia, PA 19149 | 2013-11-14 |
| Find all providers in zip 19149 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285126862 | Kisha Monique Blackmon | Pharmacy Technician | 5730 Woodcrest Ave, Philadelphia, PA 19131-2225 | 2018-05-31 |
| 1487044020 | Stefanie Black | Pharmacy Technician | 2527 Target Pharmacy, Philadelphia, PA 19150 | 2015-02-04 |
| 1003206590 | Fatima Jackson | Pharmacy Technician | 2527 Shoppers Lane, Cheltenham Square Mall, Philadelphia, PA 19150 | 2015-02-04 |
| 1154711851 | Christina Vanburen | Pharmacy Technician | 712 Landis St, Philadelphia, PA 19124-3011 | 2015-02-02 |
| 1023408838 | Elona Gjini | Pharmacy Technician | 470 Gerhard St, Philadelphia, PA 19128-3457 | 2015-02-01 |
| 1720322670 | Tieraney Simmons | Pharmacy Technician | 4417 Richmond St, Philadelphia, PA 19137-2026 | 2012-11-15 |
| 1992096051 | Rath Sun | Pharmacy Technician | 2843 Bittern Place, Philadelphia, PA 19142 | 2011-04-25 |
| 1407073307 | Aisha Dark | Pharmacy Technician | 6008 W Thompson St, Philadelphia, PA 19151-4436 | 2007-04-20 |
| 1265657118 | Betty Beckham | Pharmacy Technician | 1949 N 32nd St, Apt. B, Philadelphia, PA 19121-1705 | 2007-04-16 |
| 1124418868 | Angela Joy Luczejko | Pharmacy Technician | 1 Mifflin St, Philadelphia, PA 19148-2017 | 2015-02-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19149 |
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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.