Proact Pharmacy Services, Inc.

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

026479 Issued in NY

Legal business name

PROACT PHARMACY SERVICES, INC.

Practice address

1226 US Highway 11
Gouverneur, NY 13642-1401

Phone

(866) 287-9885

Fax

(315) 287-3330

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Lisa L Weir

Title

Third Party Administrator

Phone

(315) 287-3600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• KPH Healthcare Services, Inc.

  • Community/Retail Pharmacy
  • Syracuse, NY
  • NPI 1790892974

  Member Of

  NPD member
• KPH Healthcare Services Inc

  • Community/Retail Pharmacy
  • Springfield, VT
  • NPI 1891686549

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra V Barber, RPH

  • Pharmacist
  • Gouverneur, NY
  • NPI 1306169438
  NPD
• Melvin McCue

  • Pharmacist
  • Gouverneur, NY
  • NPI 1306168331
  NPD (past)
• Elizabeth Pharoah, PHARMD

  • Pharmacist
  • Gouverneur, NY
  • NPI 1902278310
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1154438877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 E MAIN ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421401",
            "telephone_number": "315-287-3600",
            "fax_number": "315-287-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 US HIGHWAY 11",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421401",
            "telephone_number": "866-287-9885",
            "fax_number": "315-287-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACT PHARMACY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "WEIR",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "315-287-3600"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NY",
            "license": "026479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3335468",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Marie Perrigo, PHARM.D.
• Emily Marie Petrus, LCSW-R
• Thuc Duy Phan, M.D.
• Elizabeth Pharoah, PHARMD
• Doris M Platt, RN
• Rachel I. Raven Family Health Nurse Practitioner, PLLC
• Rachel I Raven, FNP-C
• Edward Lewis Reason, D.O.
• Sylvia Jean Reimer, MD
• Brooke Richardson, MA, CCC-SLP

• Mail Order Pharmacy in Gouverneur, NY
• Providers in Gouverneur, NY by specialty
• Mail Order Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.