Courtney Alexis Washburn, PHARM D
Individual provider Active NPI Pharmacist · Granville, NY
NPI 1659693166 · NPPES record last updated Jun 10, 2020
Key facts
- NPI
- 1659693166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 053583 (NY)
- Practice address
- 116 Quaker St
Granville, NY 12832 - Phone
- (518) 642-2332
- NPI assigned
- Feb 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053583 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 053583 | NY | Yes |
Addresses
Primary practice location
116 Quaker St
Granville, NY 12832
Mailing address
116 Quaker St
Granville, NY 12832
Phone (518) 642-2332
Other providers in Granville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.