Active NPI
William Thomas Quackenbush III, RPH
- Pharmacist
- Windham, NY
National Provider Identifier
1194040717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 025979
- Practice address
- Rte 296 & South St
Windham, NY 12496-0068 - Phone
- (518) 734-3033
- NPI assigned
- Apr 7, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 025979 | NY | Primary |
Addresses
Primary practice location
Rte 296 & South St
Windham, NY 12496-0068
Mailing address
PO Box 68
Windham, NY 12496-0068
Phone (518) 734-3033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025979 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windham Pharmacy of Greene County Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Windham, NY
- NPI 1780604173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270598400000",
"number": "1194040717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 68",
"city": "WINDHAM",
"state": "NY",
"postal_code": "124960068",
"telephone_number": "518-734-3033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RTE 296 & SOUTH ST",
"city": "WINDHAM",
"state": "NY",
"postal_code": "124960068",
"telephone_number": "518-734-3033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUACKENBUSH",
"first_name": "WILLIAM",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-07",
"last_updated": "2010-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "025979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.