Corey James Duteau, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

033-0003368 Issued in VT

Practice address

434 Hurricane LN Ste 200
Williston, VT 05495-2073

Phone

(802) 655-3544

Fax

(802) 655-0123

NPI assigned

Apr 2, 2006

Last updated

Jan 14, 2020By the provider in NPPES

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

Registered Pharmacist

State licenses

Practice roles

Locations

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

• Pharmacy Direct Delivery LLC

  dba Freedom Pharmacy

  • Long Term Care Pharmacy
  • Williston, VT
  • NPI 1255753869
  NPD Authorized official

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

{
    "created_epoch": "1143936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1356302889",
    "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": {
        "last_name": "DUTEAU",
        "first_name": "COREY",
        "middle_name": "JAMES",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-02",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "045591-1",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033-0003368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dream Jar Farms LLC (FYZICAL Therapy and Balance Centers Williston)
• Sally Drudi, PT
• Catherine C Ducasse
• Susan Dumais, BCBA
• Denise M Durant, M.D.
• Charles Scott Earisman, MA
• Earth&Light, LLC (Lisa Marie Mallory Petersen)
• Jake Camron Edwards, BCBA
• Eleanor Health Professional
• Joellen Emerson, BCABA

• Pharmacist in Williston, VT
• Providers in Williston, VT by specialty
• Pharmacist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.