Owen Theriault, PHARMD.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS48724 Issued in FL

Practice address

987 Lisbon St
Lewiston, ME 04240

Phone

(207) 784-9588

NPI assigned

Aug 31, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)
• Walgreen Co.

  • Pharmacy
  • Mims, FL
  • NPI 1457534877
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1144501347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405747",
            "telephone_number": "207-784-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-784-9588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2475 US Highway 1",
            "address_purpose": "LOCATION",
            "city": "Mims",
            "state": "FL",
            "postal_code": "327543874",
            "country_code": "US",
            "telephone_number": "321-267-1788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5627",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS48724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corbin Jean Terry, DDS
• The Canvas of Life Counseling LLC
• The Chapman House
• The Grace Services LLC
• Julie Marie Thebarge, PT
• Rowan Theriault, OTR/L
• Shawn D Theriault, LSW
• Elaine C Therriault
• Autumn J Therrien, RDH
• Ethan Therrien, LCPC-C

• All providers in Lewiston, ME
• Pharmacist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.