Mary J Gagne, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

033.0104313 Issued in VT

Practice address

115 Seymour Drive
Wal-Mart Pharmacy
Derby, VT 05829

Phone

(802) 624-8011

NPI assigned

Jul 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walmart Stores East LP

  • Pharmacy
  • Derby, VT
  • NPI 1619424298
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1962810598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SEYMOUR DRIVE",
            "address_2": "WAL-MART PHARMACY",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SEYMOUR DRIVE",
            "address_2": "WAL-MART PHARMACY",
            "city": "DERBY",
            "state": "VT",
            "postal_code": "05829",
            "telephone_number": "802-624-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0104313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine A Colwell, LADC
• Richard Coutu, PHARM. D.
• Dennis E. Leblanc, D.D.S.
• Deborah J Desautels, PHARMD
• Raven Ferguson I
• Mary-Lynn Garey
• Tony J Graveline, LADC
• Thomas J Halligan Jr.
• Emily Lyn Jankowski, M.S., LCMHC
• Jessica R Judd

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.