Jill Childs

Individual provider Active NPI Pharmacist · Highland, NY

NPI 1578889028 · NPPES record last updated Apr 8, 2010

Key facts

NPI
1578889028
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
043904 (NY)
Practice address
3650 Route 9W
Highland, NY 12528-2033
Phone
(845) 691-9155
Fax
(845) 691-2749
NPI assigned
Apr 8, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
043904NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin'S Foods of South Burlington, LLC Past Accepting new patients
Martins Foods of South Burlington LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043904 NY Yes

Addresses

Primary practice location

3650 Route 9W
Highland, NY 12528-2033

Mailing address

PO Box 1000
Ms3000
Portland, ME 04104-5005
Phone (207) 885-7454

Other providers in Highland, NY

All providers in Highland, NY · Pharmacist in New York

Sources for this page

Verify at the official NPI Registry.