Pharmacy Direct Delivery LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

PHARMACY DIRECT DELIVERY LLC

Doing business as

Freedom Pharmacy

Practice address

434 Hurricane LN Ste 200
Williston, VT 05495-2073

Phone

(802) 655-3544

Fax

(802) 655-0123

NPI assigned

Jan 16, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Corey James Duteau, R.PH.NPI 1356302889

Title

Member

Phone

(802) 655-3544

Specialties & licenses 3

Addresses

Other identifiers 7

Other names 1

• Freedom Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in VT2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Corey James Duteau, R.PH

  • Pharmacist
  • Williston, VT
  • NPI 1356302889
  NPD Authorized official
• Rebecca A Crittenden, PHARMD

  • Pharmacist
  • Williston, VT
  • NPI 1962520098
  NPD (past)

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1255753869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 HURRICANE LN STE 200",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054952073",
            "telephone_number": "802-655-3544",
            "fax_number": "802-655-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 HURRICANE LN STE 200",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054952073",
            "telephone_number": "802-655-3544",
            "fax_number": "802-655-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY DIRECT DELIVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "DUTEAU",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "802-655-3544",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "033054",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NH",
            "license": "NR0990",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "038.0134046",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NR0990",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022646",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143851",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06454686",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "033054",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095901",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Freedom Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carmen Pascual Valero, DMD
• Cathy Scovell Pease, RPH
• Pediatric Care Partners - Vermont
• Sophanaroth Penh
• Spencer E Perreault, ATC
• Martha Erin Phelps, BCBA
• Sherry Jeanne Pidgeon, OTR/L
• Pine Ridge School, Inc.
• Eric Michael Place, ATC
• Planned Parenthood of Northern New England

• Long Term Care Pharmacy in Williston, VT
• Providers in Williston, VT by specialty
• Long Term Care Pharmacy in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.